March 1, 2019- What We Got Here is a Failure to Communicate

Thomas J. Madejski, MD MSSNY President
PRESIDENT’S MESSAGE
Thomas J. Madejski, MD
MSSNY President


MSSNY eNews
March 1, 2019
Volume 22  Number 9

MSSNYPAC Seal

Colleagues:

My wife Sandra and I have been blessed with five wonderful children.  The Madejski children are a combination of scientists and thespians.  My oldest son, Greg, is the other Doctor in the family— a PhD in Biomedical Engineering at the University of Rochester.  His youngest brother, Joe, is following in his footsteps as a sophomore at the U of R.  Giovanni, our middle child, is an industrial engineer in Colorado.  My daughter Jacqueline is an actress, currently performing in Key West, and my son James is a writer, currently in London working on a film.  The engineers, but especially the artists are all film buffs and we have ongoing discussions about a number of family favorite movies.

I missed the Oscars on Sunday, but am always amused, and sometimes dismayed, when life imitates art.

The quote at the top of the page is from the movie Cool Hand Luke.  Our children didn’t require a lot of guidance growing up, but when they did I would often joke that I felt we had difficulty with communication.  I felt somewhat like Paul Newman this past week in my efforts to give care to one of my patients in a Medicare Advantage Plan.

Rationing by Inconvenience

My patient, Mr.  X., had a CT of his abdomen and pelvis to assess some abdominal symptoms.  He was found to have an incidental abnormality in one of his kidneys, and my colleague in radiology recommended an ultrasound for further delineation. The ultrasound did not provide enough information and the radiologist recommended a dedicated CT of the kidney to complete the evaluation.  My office reviewed with the radiologist the need for repeat imaging.  The patient’s Medicare Advantage insurance plan required prior authorization for non-emergent imaging studies. We submitted the request and copy of the radiology report and recommendation and were denied the additional study.  I reviewed the denial, and felt that the initial reviewer had erred and submitted an appeal, indicating that my colleague in radiology recommended additional imaging.

Second Denial

Monday, I received another denial and reviewed the rationale.  The denial letter indicated that the test was denied because the patient had a CT done recently—the initial CT that incompletely identified the abnormality.  It was not clear to me who reviewed the information (a physician— it appeared) and whether they had the full clinical picture when they refused to authorize the study.  If they did have the full picture, and denied the study, I had serious concerns about the quality of care that I could deliver to my patients enrolled in this plan.  I called the 1-800 number on the denial and was connected immediately to a very friendly woman who accepted the patient identification information and then, because I was a provider, transferred me to the provider 800 number. The phone rang, and then I received frequent, repeated messages indicating that due to high call volume, there would be a delay in response.  I left the phone on speaker and completed some of my other post clinical work.  After 10- 15 minutes I was still on hold.  I hung up and went home.

Different Day, Same Response

The next morning,   I asked my assistant to contact the plan and find a medical director to discuss the case with.  In my previous experiences with other health plans, I’ve had good success in discussing a case with a physician colleague and moving forward on behalf of the patient in a mutually satisfactory way.  The plan responded that the medical director could not override a determination of the external reviewer and would not arrange for me to discuss the situation with an in- house medical director.  I was intrigued, and dismayed.   There appeared to be a problem in this system in which a physician, advocating for the proper care of their patient, could not discuss with a physician involved in the administration of the plan, concerns regarding the care of an individual patient and the quality of the plans administration of benefits for their insured. I dialed up the pleasant supervisor of appeals who dutifully took down my concern.  I did question whether the supervisor understood my concern was not just the individual patient, but a potentially flawed process that could harm other patients.  She indicated she would review it further with one of their medical directors and get back to me.  I received a call back the next morning.  The appeals supervisor told me they had reviewed my concerns, but no physician was available to speak to me.

Pulling Rank?

 Metaphorically, there was some blood on my forehead, and some puffiness to the bridge of my nose.  We had some back and forth and I was informed my only option would be to speak to her supervisor.  Trying to maintain some humor, I indicated that I thought she was the supervisor, but found that there were a number of levels of supervisors.  In these types of situations, my inclination is to work through the system, but clearly the system was not working for my patient, and not for me.  My sense of humor was failing, and I indicated that I did not wish to speak to another supervisor, but wanted to speak with a physician working for the plan.  It appeared that we were at an impasse.  Bloodied, but unbowed, I related my displeasure and indicated that I would now pursue the matter outside of the plans process.  I mentioned that I had 20,000 or so colleagues in New York who were going to hear about my experience, and indicated that if there was a medical director who wished to call me to discuss my concerns further, it might be worth their while.

I received a call back from the Medical Director of the plan within the hour.  We agreed to speak at the end of the day.  We had a pleasant conversation about my individual patient’s situation and his explanation (and to some extent an apology) about the frustrating rules imposed on the plan and their participating physicians and patients due to Medicare regulations.  He agreed to review my concern about the quality of the review and we agreed to have further discussions about the process for appeals and to review communications policies with our MSSNY VP for Socioeconomics Regina McNally.  I look forward to further discussions to improve the care of our patients and the satisfaction of our physician members.  Hopefully, this will be to the benefit of all concerned, and I won’t end up like Luke.

P.S. Just yesterday, I did have a conversation with a medical director and I think the long story will have a satisfactory (not happy because of the hours expended) ending.

This story has a number of lessons which I think are instructive to some of the discussions we will be having over the next few months in Albany and Washington.

Medicare for All?

There are ongoing discussions about single payer in New York, and Medicare for All in Washington.  Without the ability to discuss clinical concerns with administrative physicians (who also will need to be protected from reprisal when they act on behalf of a patient) in a timely, easily accessible, collegial fashion, care will be even more disrupted than it is now. Patients and physicians will have no recourse or alternative pathway in the face of an adverse determination.   If New York is going to move towards single payer, we need to have Senator Rivera and Assemblyman Gottfried pass our Collective Negotiation Bill now, as a bridge to the future, to ensure patients can get the care they require.

Physician Wellness

Physician wellness will also be further eroded due to increasing frustration with a bureaucratic, Medicare Disadvantage for all type system.  Health plans need to review the quadruple aim and pay attention to physician satisfaction as a key quality indicator.  We need to continue to work with the AMA and our State representatives to Fix Prior Auth

All healthcare financing systems have limited resources.  Patients, their physicians and other providers have ever increasing desires for care.  This constant dynamic within the system determines what actual care occurs.  Which is worse, a bureaucratic system which rations by inconvenience and can be subverted by advocacy, or an overt system with price transparency and determination of value by the purchaser?  Which is more ethical?

It is humbling, and exciting, for each of us, to have the power of this fully operational Medical Society.  Our collective voice opens doors, and our members provide valuable input on crafting the best solutions for healthcare across the state.  Many of our patients are great, articulate advocates for their interests and problems.  MSSNY physicians can complement them well, and we are acting as our best selves when we advocate on behalf of our patients who, for many reasons (illness, stigma, impairment, and developmental issues) cannot advocate on their own behalf.

Come to Albany on Wednesday

I again invite you to join me in Albany March 6th to meet with our elected representatives and share your personal story to inform them about the issues critical to you and your patients. www.mssny.org.  We have physicians and students joining us from all corners of our great state.   It should be educational (CME provided) and fun.

Our incoming President Dr. Art Fougner has agreed to try and exceed the record number of hard boiled eggs consumed in one sitting by Cool Hand Luke!

Quod si veru est per se evident, non est opus facundia

Comments? comments@mssny.org; @mssnytweet; @TomMadejski

Thomas J. Madejski, MD
MSSNY President



MLMIC Insurance Banner


Capital Update

Will You Be Joining Us in Albany Next Wednesday?
Hundreds of physician leaders from across New York State are coming to Albany next Wednesday, March 6, to advocate for their profession and their patients. Will you be joining them?

These physicians will be meeting with their local legislators, and hearing from key health care policy leaders including the Chairs of the Health and Insurance committees in the New York State Senate and New York State Assembly.  Physicians will also be given the opportunity to ask questions of these legislators.

Please join us in Albany so that together we can advocate that the Legislature:

  • Reject State Budget proposals that would impose significant cuts to physicians treating patients covered by both Medicare and Medicaid;
  • Reject State Budget proposals that would add prior authorization burdens for care provided to Medicaid patients;
  • Support State Budget proposals to improve public health including raising the age for tobacco purchase, regulating Pharmaceutical Benefit managers, and enable the creation of a Maternal Mortality Review Committee;
  • Proceed very cautiously on paradigm shifting proposals such as legalization of recreational marijuana and creating a single payor health insurance structure.
  • Support legislation to reduce excessive health insurer prior authorization hassles that delay patient care.
  • Reduce the high cost of medical liability insurance through comprehensive reforms; and
  • Preserve opportunities for medical students and residents to become New York’s future health care leaders.

Advocacy Day reading materials can be found: here.

To view MSSNY’s Physicians Advocacy Webinar, please click here.

A brief informal luncheon to which members of each House are invited to speak with their constituents will follow the morning program. County medical societies will be scheduling afternoon appointments for physicians to meet with their elected representatives. If you have any questions/comments, please contact Carrie Harring at: charring@mssny.org

(DIVISION OF GOVERNMENTAL AFFAIRS)


Physicians Urged to Oppose $80/Dual Eligible Patient Cut
Physicians are urged to continue to contact their state legislators to oppose a proposal in the 2019-20 Executive Budget that would significantly cut payments that Medicaid makes to physicians to cover the Medicare Part B deductibles of their patients covered by both Medicare and Medicaid.

You can send a letter in opposition to this harmful proposal by clicking: here

You can read MSSNY’s memo of opposition to the Legislature here: memo

While the exact cut for each physician would depend on the physician’s patient mix and services provided, we estimate that the cut would be $80 per patient.  That is because the 2019 Medicare Part B deductible is $185, and studies show that on average Medicaid only pays 56% of the Medicare fee schedule in New York.

Given that there are hundreds of thousands of patients in New York who are “dually eligible”, for practices that see a large number of dual eligible patients, this will have a profound impact.  For example, if a physician’s patient mix includes 500 such dual eligible patients, which could certainly be the case for many types of specialty physicians, it would cut payments by $40,000 per year – funds that could go toward upgrading electronic health records, hiring additional staff to allow for more time with patients, upgrading facilities or other medical equipment.

In past years, physicians have had to absorb significant cuts from Medicaid for the care that they provide to their senior and disabled patients covered by both Medicare and Medicaid, making it much harder for these physicians to deliver community-based care. Please urge your legislators know how unfair this cut is.  Please urge them to oppose balancing the state budget on the backs of dedicated community physicians seeking to deliver quality care to their patient.                                                                              (AUSTER)


State Lobby Day Banner


Measures Enacting Tighter Restrictions on Tobacco and E-Cigarettes Moves Forward in NYS Legislature
A series of bills to limit youth tobacco use moved out of the Assembly and Senate Health Committees this week including one that would raise the age of tobacco purchase to 21.  A.558/S.2833, sponsored by Assemblywoman Linda Rosenthal and Senator Diane Savino raises the purchase age of tobacco products from 18 to 21.  Also moving from the Health Committees was A.47/S.428, sponsored by Assemblymember Linda Rosenthal and Senator Brad Hoylman.

This measure prohibits the sale and distribution of flavored “e-liquids” for use in electronic cigarettes and electronic cigarettes containing such flavoring.  A.389/S.592, sponsored by Assemblymember Sandra Galef and Senator David Carlucci, would enact the “Tobacco-Free Pharmacies Act”, which would prohibit the sale of tobacco products in pharmacies. This measure was moved from the Assembly Health Committee; action is still pending in the Senate Health Committee. The Medical Society of the Society of the State of New York supports these measures. MSSNY also supports similar proposals that have been advanced in the Executive budget.  (CLANCY)


New York Health Act Reported from Assembly Health Committee
This week legislation to create a single payor system in New York (The New York Health Act A.5248, Gottfried) was reported from the Assembly Health committee to the Codes Committee. The bill passed the Health Committee by a vote of 17-8, with Democrat Robin Schimminger and all seven Republicans on the committee voting against the measure.

During the committee meeting there was extensive debate, including questions related to private insurance, out of state injuries, effects on Medicare recipients and costs of the bill related to a variety of factors such as pharmaceuticals and unemployment insurance. Gottfried estimated that it would take two years to start paying out claims. The current iteration of the bill adds long-term care insurance for New York State residents in addition to its goal of providing taxpayer-funded insurance coverage without premium or co-pays for all New Yorkers.

The bill has passed the Assembly four years in a row and is carried in the Senate by Health Chair Committee Gustavo Rivera. MSSNY continues to have a long standing policy position in support of a multi-payor system to achieve universal coverage and in opposition to a single payor system, but also recognizes that there is a wide array of physician perspectives on this issue.  MSSNY looks forward to continued open and honest dialogue and careful evaluation of the nuances such a far-reaching proposal related to our healthcare and insurance system to ensure that New York moves forward in a manner that assures that patients access to needed care from the physician of their choice is not impaired.

When the legislation was re-introduced a few weeks back, MSSNY President Dr. Thomas Madejski issued the following statement (Statement by Thomas Madejski, MD) that highlighted improvements to the legislation to place parameters around prior authorization requirements and provide a fairer process to negotiate payments for patient care, but also MSSNY’s ongoing strong concerns with moving away from a multi-payor insurance system. (AVELLA, AUSTER)


Medical Jobs Ad

Governor Signs Into Law “Red Flag” Law
Governor Andrew Cuomo this week signed into law S.2451/A. 2689, sponsored by Senator Brian Kavanagh and Assemblymember JoAnne Simon, which allows law enforcement officials, family and household members, and certain school officials to seek a court order requiring a person likely to harm themselves or others to surrender any firearms in their possession. This bill, commonly referred to as a “red flag” law, would establish an Extreme Risk Protection Orders (ERPO) which is an order of protection prohibiting a person from purchasing, possessing or attempting to purchase or possess a firearm, rifle or shotgun.    Under the measure, a police officer, a family or household member, a school administrator or his/her designee, can request a court-issued order of protection.  The bill provides grounds for the request and surrendering of the firearm.  MSSNY’s Taskforce on Firearm Safety recently recommended (and the MSSNY Council agreed) that MSSNY support the concept of “red flag” provisions.

Still awaiting the governor’s signature are a series of bills that would help ensure firearm safety.  S.2374/A.2690, sponsored by Senator Michael Gianaris and Assemblymember Amy Paulin, would establish a background check waiting period of up to 30 days.  S.2248/A.2448, sponsored by Senator Luis Sepulveda and Assemblymember Patricia Fahy, would prohibit the possession of a device (bump stock) that accelerates the rate of fire of a firearm.

Also passed by the Legislature was S.101A/A.1715, sponsored by Senator Todd Kaminsky and Assemblymember Judy Griffin that prevents K-12 schools from authorizing anyone other than a security officer, a school resource officer or a law enforcement officer from carrying a firearm on school grounds.  Senator Shelley Mayer and Assemblymember Linda Rosenthal sponsored legislation that directs the state police to devise regulations for gun buyback programs to ensure that such programs are operated consistently throughout the state.  Senator Anna Kaplan and Assemblymember Pamela Hunter were the sponsors of S.2438/A.1213, which would require out of state applicants for gun permits to allow NY permitting authorities to review out-of-state mental health records.

In March 2018, the MSSNY House of Delegates took action to support legislation that requires a waiting period and background checks prior to the purchase of all firearms, including person-to-person transfer, internet sales and interstate transactions for all firearms.  The MSSNY HOD also supported legislation that blocks the sale of any device or modification – including but not limited to bump stocks, which convert a firearm into a weapon that mimics fully-automatic operation.  MSSNY supports legislation that would ban the sale and/or ownership of high-capacity magazines or clips and high-speed, high-destruction rounds. (MSSNY Policy 260.898 and Policy 260.899). (CLANCY)


NY Health Foundation Issues Report Promoting NY’s Successful Law to Limit Patient Surprise Bills
With the United States Congress looking at legislation to address the issue of patients facing “surprise” out of network medical bills across the country, the New York State Health Foundation issued a report this week highlighting the success that New York’s 2014 law has had in reducing such bills.

While New York’s law contains a number of different components to expand network adequacy and comprehensive out of network coverage, its most notable component assures that patients are not financially responsible for medical bills for “surprise” Emergency Department and hospital out-of-network services that are above the patient’s standard in-network copayment, deductible, or coinsurance amount.  Physician payments for these services are determined through informal negotiation between the insurer and physician, with either party having the right to go to a simplified expedited independent dispute resolution (IDR) process if such negotiations for fair payment are not successful (for more information about the law, click here).  The report noted that the percent of out-of-network emergency department services that were billed decreased from 20.1% in 2013, before the law was passed, to 6.4% in 2015, after its implementation.

As Congress debates this issue, MSSNY has written to the New York Congressional delegation, urging that any legislation to be considered is consistent with New York’s comprehensive law (see MSSNY’s letter here).   New York’s comprehensive law addressing this issue has been hailed as a model for the rest of the country because of the delicate balance it struck among key health care stakeholders (such as physicians, hospitals and health insurers) to protect patients from large “surprise” medical bills, while at the same time being constructed in such a way that it did not adversely affect the ability of hospital emergency departments to have adequate on-call specialty physician care.

The NYS Health Foundation report also included some recommendations for improving New York’s law, including stronger insurer network adequacy requirements, enhanced insurer and provider disclosure of network participation, further limiting balance billing in ER out of network situations, and extending applicability to air ambulance services.  MSSNY is continuing to review the feasibility of these recommendations. (AUSTER)



Doctor's Day Banner


Assembly Passes Legislation to Exempt Nursing Home from E-Prescription Requirement
This week the Assembly passed Assemblyman Richard Gottfried’s bill (A1034-A) that would exempt nursing homes’ prescription of oral medication from the state requirement that all prescriptions be electronically submitted.   As was recently discussed at MSSNY’s Long-Term Care subcommittee meeting, nursing homes present unique circumstances that make compliance with the current mandate impractical. Physicians are not physically present 24 hours a day, so RNs are allowed to take orders for medication safely and without delay for the residents who need them. The physician would then sign the oral order within 48 hours. This is an extension of an already existing exemption established by the NYS Department of Health that is set to expire on 3/24/19. It would set forth in statute that a waiver from this requirement would be extended to March 2021. The bill does not yet have a Senate sponsor. (AVELLA)


DOH Announces Prevention Agenda 2019-2024 at 6th Annual Population Health Summit
On February 2nd, MSSNY staff and Dr. Geoffrey Moore (Tompkins County) participated in the 6th Annual Population Health Summit: “Becoming the Healthiest State for People of All Ages – Incorporating Health Across all Policies and Age Friendly Principles into the Prevention Agenda 2019-2024” hosted by the NYS Department of Health. The Summit sought to deepen and extend the understanding of ongoing efforts in New York State and nationally that demonstrate effective collaboration between public health, health care, and other sectors to advance population health.

The Prevention Agenda 2019-2024 will focus on preventing chronic diseases; promoting a healthy and safe environment; promoting healthy women, infants, and children; preventing mental and substance use disorders; and preventing communicable diseases. To learn more about the Prevention Agenda 2019-2024 click on this link (HARRING)


CPH Banner

Legislation to Help Prevent Sudden Cardiac Arrest in Student Athletes Moving in NYS Assembly
Legislation to create an educational program on sudden cardiac arrest moved out of the Assembly Health Committee this week.  A.4892/S.3269, sponsored by Assemblymember Michael Cusick and Senator Andrew Lanza, would add the development of an educational and outreach program preventing sudden cardiac arrest among student athletes to the Health Care and Wellness Education and Outreach Program that currently exists in the New York State Department of Health.

The Medical Society of the State of New York supports this measure.  Under the bill’s provisions, DOH will provide educational materials regarding sudden cardiac arrest to students and their parents and guardians. The materials would be developed in conjunction with the Commissioner of Education, the Medical Society of the State of New York, the New York Chapter of the American Academy of Pediatrics, and the American Heart Association.  They would include an explanation of sudden cardiac arrest, a description of early warning signs and an overview of options that are privately available for screening. This legislation would establish a program similar to one being used in New Jersey that requires the development of brochures that could be given to parents as well as pediatricians. (CLANCY)


Registration now open for Medical Matters: Disaster Medicine: Every Physician’s Second Specialty on March 27th at 7:30 AM
The Medical Society of the State of New York will conduct a webinar entitled Disaster Medicine: Every Physician’s Second Specialty on March 27, 2019 @ 7:30am.

Register now for:

Medical Matters: Disaster Medicine: Every Physician’s Second Specialty

Wednesday, March 27th @ 7:30am
Register here.
Faculty: Lorraine Giordano, MD, FACEP, FAADM

Educational Objectives:

Identify core preparedness competencies every physician should know

Explore essential elements of preparedness plans for staff, patients, and family

Describe available courses, resources and organizations to obtain disaster preparedness education and training. 

The Medical Society of the State of New York is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.

The Medical Society of the State of New York designates this live activity for a maximum of 1.0 AMA/PRA Category 1 credits™.  Physicians should claim only the credit commensurate with the extent of their participation in the activity. (HOFFMAN, CLANCY)


NY Rx Card Banner


Registration Now Open for New Veterans Matters CME Webinar March 14th
The Medical Society of the State of New York is proud to announce our newest Veterans Matters webinar scheduled for March 14th at 7:30am. This webinar is entitled Military Culture: Everything Physicians Need to Know About Veterans as Patients.  Register for this program here.

Veterans Matters: Military Culture: Everything Physicians Need to Know About Veterans as Patients

When: Thursday, March 14 2019 at 7:30am – Register here.

Faculty: Lt. Col Lance Allen Wang, & Marcelle Leis, CM Sgt. (Ret)

Educational Objectives:

  1. Describe the unique aspects of military culture and how they impact patients who are veterans.
  2. Explain the Dwyer Peer-to-Peer program as a resource to assist veteran patients re-acclimating from a group to an individual mentality.
  3. Review and identify resources to improve physician’s ability to fully treat veterans who are transitioning back into civilian life.

Additional information or assistance with registration can be obtained by contacting Melissa Hoffman at mhoffman@mssny.org or (518)465-8085                                 (HOFFMAN)

The Medical Society of the State of New York is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.

The Medical Society of the State of New York designates this live activity for a maximum of 1.0 AMA/PRA Category 1 creditsä.  Physicians should claim only the credit commensurate with the extent of their participation in the activity.


For more information relating to any of the above articles, please contact the appropriate contributing staff member at the following email addresses:

pschuh@mssny.org mauster@mssny.org  pclancy@mssny.org  mavella@mssny.org
charring@mssny.org

Garfunkel Ad


eNews

MSSNY Member Event at the Westbury Manor: “Is Single Payer Legislation Coming to New York? 

Moe Auster MSSNY, Single Payer Seminar, Westbury David Podwell, MD, Single Payer Seminar, Westbury
Single Payer Seminar, Westbury Single Payer Seminar, Westbury

Response to Claim that Majority Legalization of Assisted Suicide
Dr. Thomas Madejski, the president of the Medical Society of the State of New York (MSSNY), wrote in a letter to the editor of the Albany (NY) Times Union (2/22) that MSSNY “has strong concerns with the articulation in the article ‘State’s physicians support aid in dying,’ Jan. 29, that a majority of New York doctors are in favor of physician assisted suicide.” Madejski says that “the survey from Compassion & Choices that was referenced in the article, like the 2017 Medical Society survey, is not a scientific sample representative of the nearly 100,000 New York-licensed physicians as a whole.” Madejski adds that MSSNY’s “Task Force on End of Life continues to discuss many matters related to end-of-life care and whether Medical Society’s long-standing position on physician assisted suicide should be re-evaluated.”


NY Services for Senior Citizens Strained by Record High Elderly Population
The Wall Street Journal (2/27, King, Subscription Publication) reports a study published by the Center for an Urban Future indicates that people aged 65 and older now make up 16 percent of New York’s population, a record high. This in turn is straining state and county services for senior citizens, such as home-care aides and meal delivery.


A Patient Just Sexually Harassed An Employee of My Practice: What Can I Do?
By Andrew Zwerlingftnref1″>[1]

It seems like a normal day at your medical practice until one of your female physician-employees informs you that a male patient grabbed and tried to kiss her when she was conducting a routine examination.  The patient fled the practice immediately after this event.

Putting aside the issue of whether your employee may file criminal charges against the patient – she can – an issue confronting you as the physician-owner of the practice is whether it is appropriate to discharge the offender as a patient of your practice.   As the owner of the practice, under New York law you are required to intervene when put on notice of acts of sexual harassment and assault in your workplace and may be held accountable if you fail to do so.  Here, in order to ensure the safety of your staff, one measure you can take is to discharge or terminate the patient.

Significantly, however, there are myriad components to the termination process that should be undertaken in the effort to insulate you and your practice from a claim of patient abandonment.  You should inform the patient of the termination in writing and through a method of delivery that allows you to track and confirm receipt by the patient, and also send the letter by first class mail.

In the letter you should advise the patient 1) of the reason for the termination; 2) that your practice will be available to him for urgent or emergent care only for a period of thirty (30) days while he transitions his medical care to another qualified provider; 3) that he should contact his insurance provider to assist him in identifying local medical providers to manage or arrange for any ongoing treatment he may need; and 4) that when he finds another provider, that provider may contact your practice to arrange for the transfer of the patient’s clinical records.  You may, but are not required to, provide the patient with a list of other similar providers in the area that he can contact to arrange for ongoing treatment, but cannot recommend any particular provider.  Finally, you should maintain a copy of the termination letter in your files.

[1] Andrew L. Zwerling is a Partner-Director at Garfunkel Wild P.C. with over 36 years as a trial and appellate lawyer in State and Federal courts, including his successful argument before the United States Supreme Court.  He specializes in employment law, and conducts internal investigations for clients relating to sexual harassment and other personnel issues.   His may be reached at 516-393-2581 and by email at azwerling@garfunkelwild.com.


Physicians Accepted $40M in Kickbacks from Texas Hospital, Feds Say
The federal trial for 10 defendants, including four surgeons and a pain physician, accused of participating in a $200 million healthcare fraud scheme kicked off last week, according to The Dallas Morning News.

Five things to know:

  1. The trial, which is expected to last up to two months, centers on bribes and kickbacks now-defunct Forest Park Medical Center in Dallas allegedly paid to physicians and surgeons to steer surgeries to the hospital.
  2. The scheme, which began in 2009 and ran through 2013, involved paying surgeons for referring patients to FPMC, which was out of network with payers. Instead of billing patients for out-of-network copayments, hospital executives and physicians allegedly assured patients they would pay in-network prices. Those involved in the scheme allegedly concealed the patient discounts and wrote off the difference as uncollected bad debt.
  3. There were 21 defendants charged in the scheme in 2016, 11 of whom have pleaded guilty and are expected to testify on behalf of the government at trial, according to The Dallas Morning News.
  4. The $200 million healthcare fraud scheme allegedly involved FPMC officials making $40 million in illegal payouts to surgeons and others in exchange for referrals. Although the $40 million in payments looked legitimate, they were really “bribes and kickbacks,” a government lawyer told the jury during opening arguments on Feb. 21, according to Law360.
  5. Several of the defendants have denied any wrongdoing. They claim healthcare attorneys told them the marketing agreements they entered into, which are at the center of the kickback allegations, were not illegal, according to The Dallas Morning News. (Becker’s Hospital Review, Feb. 27)

More Independent Hospitals Joining Systems Amid Financial Struggles
Modern Healthcare (2/23) reported “stand-alone hospitals’ financial situations are increasingly tenuous,” with 53.2 percent operating at a loss “for each of the past five years, which is more than twice the share of system-owned hospitals, according to an analysis of Modern Healthcare Metrics.” Among rural standalone hospital, the number increases to 60.5 percent. Meanwhile, “independent government-owned hospitals, many of them in rural areas, had an average annual operating margin of negative 16.6% and a $15.8 million operating loss in 2016 compared with a negative 7.9% operating margin and $8.4 million operating loss for their system-owned peers, according to a white paper from Healthcare Management Partners, Waller Lansden Dortch & Davis, and Taggart, Rimes & Graham.” Such financial struggles are leading independent hospitals to join larger health systems; “nearly three-quarters of all hospitals were part of multihospital systems in 2017, up from 70.4% in 2012, according to Metrics data.” (Becker’s Hospital Review, Feb. 27)


As Congress Looks at ‘Surprise’ Billing, a Review of NY’s Law
The New York State Health Foundation on Monday published a review of the state’s law regarding surprise bills, implemented in 2015, to highlight its successes and limitations.

Under the law, patients are responsible for their in-network payment only in cases when they did not give written consent to be treated by an out-of-network provider, including in emergencies. The law also created a dispute-resolution process for providers and insurers to enter binding arbitration over bills.

The law seems to have had its intended effect. The percentage of out-of-network emergency department services billed dropped from 20.1% in 2013 to 6.4% in 2015, according to a study from researchers at Yale University cited in the report.

“We found with our review that the law is working quite well,” said Sharrie McIntosh, vice president for programs at NYSHealth.


Study Underscores Cost Implications of Trend on Taxpayers and Beneficiaries
This study demonstrates that the overall trend continues and is dramatically reshaping the landscape for physicians by creating an increasingly concentrated health care system that costs more.  This is because the same services performed in the hospital outpatient setting are reimbursed by Medicare at higher rates compared to the independent physician office setting. Previous PAI-Avalere research underscored the impact of this policy as it relates to health care spending by taxpayers and patients:

  • Medicare paid $2.7 billion more for four specific cardiology, orthopedic, and gastroenterology services performed in the hospital outpatient setting than if the same services were delivered in the physician office setting from 2012 to 2015.
  • For these same services, Medicare beneficiaries faced $411 million more in out-of-pocket costs due to higher cost-sharing.

Sexual Harassment Webinar
Train the Trainers”: Impact on Healthcare System and Medical Profession

March 20, 2019
12:00pm-1:00pm

REGISTER HERE

 The issue of sexual harassment in the workplace has been the center of a staggering amount of media attention and of a surge in litigation activity. Consistent with this momentum, New York State recently mandated that all employers are required to have a sexual harassment policy containing specified criteria in place by October 9, 2018, and to conduct sexual harassment prevention training by October 2019. (New York City requirements are slated to take effect in April 2019.)

The issue of sexual harassment takes on particular significance for the healthcare industry, because there is an established nexus between disruptive behavior, which includes sexual harassment, and adverse patient outcomes and medical errors.

Sexual Harassment Train the Trainer FREE Webinar on March 20 12 noon

At this time, Garfunkel Wild will be offering a complimentary “Train the Trainers” webinar on the issue of sexual harassment.  The live webinar will be presented on March 20, 2019, from 12 noon to 1:00pm.  For those individuals who are unable to participate in the webinar at that time, MSSNY will be placing a recorded version of that webinar on the MSSNY website to facilitate access to the webinar for MSSNY members.

By the conclusion of the “Train the Trainers” webinar, you will know how to teach your employees:

  • How to identify the more subtle forms of sexual harassment.
  • The impact of sexual harassment on the quality of care and the victim.
  • Practical advice on how to diminish and prevent sexual harassment at your practice.
  • How to respond to sexual harassment in the workplace.
  • Guidelines on how to comply with statutory mandates relating to sexual harassment.

Garfunkel Wild offers individual or group training, on-site or off-site training, as well as webinar modules that can serve to satisfy this new statutory mandate for your employees. If you would like to set up a personal training, please contact Andrew L. Zwerling at 516-393-2581 or azwerling@garfunkelwild.com.


CME PROGRAMS

Two CME Programs at the HOD: Protect Your Patients and Women in Medicine
You don’t want to miss these! REGISTER NOW at sbennett@mssny.org

Thursday, April 11, 2019, 3:00 – 4:00 pm, Grand Ballroom D/E, Westchester Marriott, Tarrytown

Protect Your Patients, Your Practice, and You!*

Join us at the OMSS Annual Meeting for an interactive presentation by Garfunkel Wild on MEDICAL RECORDS, including the impact on records of the controlled substances “epidemic,” what to consider when emailing and texting, dealing with non-compliant patients, additional areas of exposure from EMRs, and what to include in a telemedicine record.

Business meeting to follow, 4:00 – 6:00, Putnam Room


Friday, April 12, 2019, 5:00 – 6:30 pm, Grand Ballroom B, Westchester Marriott, Tarrytown 

Women in Medicine: Reaching Your Potential Now!**

A panel presentation at the Women Physicians Caucus on PAY, PROMOTIONS and CAREER ADVANCEMENT in Academic Medicine, Private Practice and Organized Medicine

Gender imbalance in medicine and academic sciences still exists. Hear three women physicians who have achieved significant leadership positions describe their own pathways, provide advice on how to achieve success, and show how to overcome gender bias, gender pay gaps and system-wide barriers to career advancement. Learn how to achieve success in your career!

* The Medical Society of the State of New York (MSSNY) is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.

The Medical Society of the State of New York designates this live activity for a maximum of 1.0 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity. 

** The Medical Society of the State of New York (MSSNY) is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.

The Medical Society of the State of New York designates this live activity for a maximum of 1.5 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.


Classified

RENTAL/LEASING SPACE

 

Office Rental 30 Central Park South.
Two fully equipped exam, two certified operating, bathrooms and consultation room.  Shared secretarial and waiting rooms. Elegantly decorated, central a/c, hardwood floors. Next to Park Lane and Plaza hotels. $1250 for four days a month. Available full or part-time. 212.371.0468drdese@gmail.com.


5th Ave Medical Office for Share
Facing Central Park in exclusive building, ground floor, separate entrance.
Perfect for psychiatrist, physiatrist, osteopath, or other.
880 5th Avenue (between 69th and 70th Sts.), New York, N.Y.
Please call 917-715-2464


Rare Find — Great Office Share
Wonderful office share in terrific location at great price. Available Monday, Wednesday, Friday and weekends. Choice of smaller windowed consultation room with adjoining exam room or big windowed consultation room with one or two exam rooms. Beautiful bright rooms, lovely reception area and front . First-rate building on 58th Street between Park and Lexington. Rent by day (about $180). Front desk and office management available if needed, along with many other amenities, including internet, ultrasound, EMG Kitchen, optional C Arm. Willing to make changes for new tenant. Call 646-642-0700.


Are You Trying to Lease Your Medical Office or Sell Your Medical Practice? Trying to Sell New or Used Medical Equipment?
Clineeds, the new online platform designed for medical providers. With Clineeds you can lease your medical officeshared your office spacebuy and sell used medical equipment, or post healthcare job opportunities. LISTING IS FREE! Why wait? Click here to sign-up: www.clineeds.com/sign-up


PHYSICIAN OPPORTUNITIES

Nurse, RN Utilization Review Full-Time-Westbury, NY (In-office position only)
Excellent opportunity for a RN who is seeking a position performing utilization review.  We require 1-2 years recent experience in hospital and/or insurer utilization review and experience using Interqual criteria and/or MCG Guidelines. Data entry/PC skills a plus. Benefits include 401(k), paid vacation and holidays. Send resume and salary requirements to: Empire State Medical Scientific and Educational Foundation, Inc. Human Resource Department e-mail: chunt@mssny.org  Fax: (1-516) 833-4760 Equal Oppty Employer M/F


Pediatrician BC, P/T
Seeking motivated, enthusiastic pediatrician for P/T position in solo practice in Long Island. Coverage will increase over time. Great opportunity for those seeking part time hours in an established practice.   Fax resume to 516-858-2389.


Physician Wanted to Help Shape the Future of Primary Care
98point6 is a healthcare technology company committed to delivering more affordable, accessible, high-quality primary care. To support our mission, the insights of forward-thinking physicians like you are invaluable. Members of our exclusive Primary Care Council have no clinical responsibilities and are generally compensated for participation, which requires only a few hours per year.

Interested? Learn more and apply today at www.98point6.com/pcc



CALL FOR RATES & INFO. CHRISTINA SOUTHARD: 516-488-6100 ext. 355

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 


Council – March 5, 2019

AGENDA
MSSNY Council Meeting
Tuesday, March 5, 2019, 1:00 p.m.
Albany Renaissance Hotel
144 State Street
Albany, NY  12207

 

A. Call to Order and Roll Call

B. APPROVAL of the Minutes of January 24, 2019

C. New Business (Informational/Action Items)

1. President’s Report:
Introduction to the New MSSNY Mobile App for the House of Delegates (verbal)
Presented by:
Mr. Stephen Sachs, MSSNY’s Website Administrator

2. Board of Trustees Report – Dr. Robert Hughes will present the report  (handout)

3. Secretary’s Report – Dr. Frank Dowling will present the report

4. MLMIC Update – Mr. Marc Craw will present the report (verbal) 

5. AMA Delegation Report – Dr. John Kennedy will present the report (verbal)

6. MSSNYPAC Report – Dr. Joseph Sellers will present the report (handout)

7. MESF Update – No written report submitted

8. Commissioners (Action Items – For Council Approval)
    Commissioner of Science & Public Health, Joshua M. Cohen, MD

  1. Resolution 2018-63 – Integrating Medical Records
  2. Resolution 2018-150 – Common Sense Prostate Cancer Screening
  3. Revisions to MSSNY Policy 125.996 Screening Programs and Interventions Most Beneficial in Improving the Overall Public Health

DReports of Officers

  1. Office of the President – Thomas J. Madejski, MD
  2. Office of the President-Elect – Arthur C. Fougner, MD
  3. Office of the Vice President – Bonnie L. Litvack, MD
  4. Office of the Treasurer – Joseph R. Sellers, MD
        Financial Statement for the period 1/01/18 to 12/31/18
  5. Office of the Secretary – Frank G. Dowling, MD
  6. Office of the Speaker – Kira A. Geraci-Ciradullo, MD

E.  Presentations

2:00 p.m.
PowerPoint – “Physician Wellness” (handout)
Presented by:
Arthur Hengerer, MD, Chair BPMC
Robert Catalano, MD, MBA Executive Secretary, OPMC
Mr. Keith Servis, OPMC Director
Mr. Stephen Boese, Executive Secretary, Board of Medicine


2:45 p.m.
PowerPoint – “Efforts to Stop Legalization of Marijuana in New York State” (handout)

Presented by:
Kevin A. Sabet, PhD. President & CEO
Smart Approaches to Marijuana (SAM)


3:45 p.m
Discussion – “Overview of the Proposal to Legalize Marijuana in New York State” (verbal)
Presented by:
Mr. Axel Bernabe, Associate Counsel for Health
Office of  New York Governor Andrew Cuomo
Mr. Jason Starr, Assistant Counsel
Office of  New York Governor Andrew Cuomo


F.
  Reports of Councilors (Informational Items)

  1. Kings & Richmond Report – Parag H. Mehta, MD
  2. Manhattan & Bronx Report – Joshua M. Cohen, MD
  3. Nassau County Report – Paul A. Pipia, MD
  4. Queens County Report – Saulius J. Skeivys, MD
  5. Suffolk County Report – Maria A. Basile, MD
  6. Third District Branch Report – Brian P. Murray, MD
  7. Fourth District Branch Report – Gregory L. Pinto, MD
  8. Fifth District Branch Report –Howard H. Huang, MD
  9. Sixth District Branch Report – Robert A. Hesson, MD
         (no report submitted)
  10. Seventh District Branch Report – Janine L. Fogarty, MD
  11. Eighth District Branch Report – Edward Kelly Bartels, MD
  12. Ninth District Branch Report –  Thomas T. Lee, MD
  13. Medical Student Section Report – Breyen Coffin
  14. Organized Medical Staff Section – Stephen F. Coccaro, MD
  15. Resident & Fellow Section Report – Justin Fuehrer, DO
  16. Young Physician Section Report – L. Carlos Zapata, MD
         (no report submitted)

G.  Commissioners (Informational Items)

1. Commissioner of Communications, Maria A. Basile, MD, MBA
  a.  Report from the Division of Communications 

2. Commissioner of Governmental Relations, Gregory Pinto, MD
  a. HIT Committee Minutes, February 1, 2019

3. Commissioner of Membership, Parag H. Mehta, MD
    a. Membership Committee Report

4.  Commissioner of Science & Public Health, Joshua M. Cohen, MD 
  1. Addiction & Psychiatric Medicine Committee Minutes, January 18, 2019
  2. Bioethics Committee Minutes, February 8, 2019
  3. Health Care Disparities Minutes, January 25, 2019
  4. HLC Committee Minutes, October 17, 2018
  5. Infectious Diseases Committee Minutes, January 17, 2019
  6.  PMFH Committee Minutes, February 7, 2019
  5. Commissioner of Socio Medical Economics, Howard H. Huang, MD
  (No written report submitted)

H. Report of the Executive Vice President, Philip Schuh, CPA, MS

I. Report of the General Counsel, Garfunkel Wild, P.C., James Derling, Esq.
   (No written report submitted)

J. Report of the Alliance, Barbara Ellman
   (No written report submitted)

K. Other Information/Announcements 

  1. AMA Surprise Bill Sign-On Letter
  2. MSSNY Surprise Bill Letter to Senator Schumer
  3. PAI Comments on HIPAA RFI
  4. MSSNY Statement on Legalization of Cannabis Public Hearing
        http://www.mssnyenews.org/press-releases/legalcannabis/#can
  5. MSSNY Statement on Revised New York Health Act Legislation
        http://www.mssnyenews.org/press-releases/health-act-  legislation/#leg   
  6. Poughkeepsie Journal Article    https://www.poughkeepsiejournal.com/story/news/2019/02/20/marijuana-legalization-ny-under-attack-cops-educators-docs/2905268002/

L. Adjournment

 

 

 

 

 

February 22, 2019 – Federal and State Issues

 

Thomas J. Madejski, MD MSSNY President
PRESIDENT’S MESSAGE
Thomas J. Madejski, MD
MSSNY President


MSSNY eNews
February 22, 2019
Volume 22  Number 8

MSSNYPAC Seal

Colleagues:

Last week your MSSNY leadership and staff attended the AMA National Advocacy Conference in Washington, D.C.  We enjoyed presentations from a number of elected officials, HHS Secretary Alex Azar, various media personalities and AMA content experts about the many issues affecting our patients and our practices.  The highlight of the meeting was the Nathan Davis Awards dinner, Tuesday night.  Nathan Davis, a MSSNY member from Broome County helped to found the AMA in 1857.  I was proud to accept an award for our longstanding MSSNY member Dr. Richard Izquierdo for his work to improve the healthcare of his patients in his underserved community.

Doc Izquierdo is a trailblazer whose efforts have resulted in the creation of a healthcare system that focuses on treatment of the underserved, and was a pioneer in improving the educational system to improve recruitment of minority students into healthcare fields.

On the Hill

 Tuesday and Wednesday were spent on the Hill meeting with our elected representatives and staff to discuss the many current issues under discussion.  We were happy to visit the offices of Senate Majority Leader Schumer, Senator Gillibrand, Rep. Elise Stefanik, Rep. Paul Tonko, Rep. Brian Higgins, Rep. Elliott Engel, and Rep. Joe Morelle among others.  We reviewed legislative proposals for fixing some of the flaws in the ACA, Medicare funding, current activities to combat the opiate crisis, and challenges related to marijuana.  There was uniform support to changing marijuana from Schedule I to Schedule II, to support high quality research to address the many questions regarding its medicinal use and safety concerns with expanding access to marijuana in some of the states.  MSSNY is very supportive of efforts to better define the medicinal properties of various cannabis derived products for treatment of various conditions.  That research should also answer the many questions about safety and consequences of chronic use for patients, and inform decisions on non-medicinal use.

Expanded Marijuana Use for Recreational Purposes

Subsequently, Governor Cuomo’s Council and other staff briefed the New York State Legislature on their proposal to expand medicinal and adult recreational use.  Many questions remain in regard to promoting increased use of marijuana and related hemp products both medicinally, and as a lifestyle choice.  MSSNYs concern relates to a paucity of data on long term efficacy and risks associated with chronic use.  Last week JAMA Psychiatry published a meta-analysis raising concerns about increased depression and suicide rates in association with marijuana use.

Societal mental health issues and teenage and young adult suicide is a major issue throughout the country.  Emerging concerns regarding increasing marijuana usage among youth should give us pause before making it more accessible to society in general, even with the protections in the Governor’s proposal.  States with adult use programs have higher rates of child and adolescent use.

We should work with the Governor’s Office and the Legislature to address any disparities in the application of the law to minor users of marijuana.  We should urge our Federal representatives to reschedule marijuana to allow high quality, large population studies of this complex moiety to inform us on its proper place in the compendium of treatments available for our patients.  That research should also help to determine whether it is safe for long term use and made available more widely for non-medicinal purposes.  Federal action would also help to protect our children, teens, and young adults from the effect of legalization in neighboring states and countries.

Join me in Albany March 6th to help your fellow physicians inform our representatives on these many important topics.

Primum, non nocere!

Comments? comments@mssny.org; @mssnytweet; @TomMadejski

Thomas J. Madejski, MD
MSSNY President



MLMIC Insurance Banner


Capital Update

Join Us For: MSSNY’s Annual “Physician Advocacy Day” (3/6)!
Physician leaders from across New York State will be coming to Albany on March 6, to advocate for their profession and their patients. Will you be joining them?

With nearly 40 newly elected legislators in Albany, the need for physician advocacy and grassroots involvement is greater than ever. It’s vital for physicians to forge new relationships, as well as strengthen existing relationships to ensure the physician community’s message is heard about policies that could impact patient care.

Please plan to participate in MSSNY’s “Physician Advocacy Day” that will be held on Wednesday, March 6th in the Lewis Swyer Theatre in the Egg located at the Empire State Plaza, Albany NY. Click here to register!

Join Us To Urge Your Legislators To:

  • Proceed very cautiously on paradigm shifting proposals such as legalization of recreational marijuana (proposed in the State Budget) and creating a single payor health insurance structure.
  • Reject proposed unfair cuts to physicians treating patients covered by both Medicare and Medicaid;
  • Reject proposals that would add prior authorization burdens for care provided to Medicaid patients;
  • Support legislation to reduce excessive health insurer prior authorization hassles that delay patient care.
  • Reduce the high cost of medical liability insurance through comprehensive reforms.
  • Preserve opportunities for medical students and residents to become New York’s future health care leaders.

A brief informal luncheon to which members of each House are invited to speak with their constituents will follow the morning program. County medical societies will be scheduling afternoon appointments for physicians to meet with their elected representatives. If you have any questions/comments, please contact Carrie Harring at charring@mssny.org.


Physicians Urged to Oppose $80/Dual Eligible Patient Cut 
Physicians are urged to continue to contact their state legislators to oppose a proposal in the 2019-20 Executive Budget that would significantly cut payments that Medicaid makes to physicians to cover the Medicare Part B deductibles of their patients covered by both Medicare and Medicaid.  You can send a letter in opposition to this harmful proposal by clicking here.  You can read MSSNY’s memo of opposition to the Legislature here.

While the exact cut for each physician would depend on the physician’s patient mix and services provided, we estimate that the cut would be $80 per patient.  That is because the 2019 Medicare Part B deductible is $185, and studies show that on average Medicaid only pays 56% of the Medicare fee schedule in New York.

Given that there are hundreds of thousands of patients in New York who are “dually eligible”, for practices that see a large number of dual eligible patients, this will have a profound impact.  For example, if a physician’s patient mix includes 500 such dual eligible patients, which could certainly be the case for many types of specialty physicians, it would cut payments by $40,000 per year – funds that could go toward upgrading electronic health records, hiring additional staff to allow for more time with patients, upgrading facilities or other medical equipment.

In past years, physicians have had to absorb significant cuts from Medicaid for the care that they provide to their senior and disabled patients covered by both Medicare and Medicaid, making it much harder for these physicians to deliver community-based care. Please urge your legislators know how unfair this cut is.  Please urge them to oppose balancing the state budget on the backs of dedicated community physicians seeking to deliver quality care to their patient.         (AUSTER)


 

State Lobby Day Banner


Governor Releases “30-Day” Budget Amendments That Could Cause Significant Medicaid Cut
Late last week, Governor Cuomo provided the State Legislature with his “30-day amendments” to the Executive Budget proposal that was formally introduced on January 15. While staff is continuing to review the entire proposal, there are major implications for the health care sector that are designed to close a $2.3 Billion budget gap for FY 2019-20.  Of significant concern is a proposal that would impose an across the board Medicaid cut to all covered Medicaid providers totaling $190 million.  This could translate to a per service cut to physicians and other health care providers of approximately 0.8%.

Moreover, there were significant cuts to hospitals and nursing homes announced including the proposed elimination of a scheduled $550 million increase in Medicaid payments that had been announced in late 2018.  Furthermore, the Governor proposed a revised version of an “opioid tax” on manufactures and distributors that had been approved by the State Legislature as part of last year’s Budget, but had been struck down by the courts.  The governor has also proposed re-convening the Medicaid Redesign Team (MRT) that had met in the early years of the Cuomo Administration to arrive at ways to increase quality care delivery and produce savings for the system.  Please remain alert for further updates on these issues. (AUSTER)


NYS DOH Sends Letter To Physician Regarding Opioid Prescribing
The New York State Department of Health, Bureau of Narcotic Enforcement, has sent a letter to physicians and institutions apprising them that, effective April 1, 2018, legislation was enacted that  no opioids shall be prescribed to a patient initiating or being maintained on opioid treatment for pain which has lasted more than three months or past the time of normal tissue healing, unless the medical records contains a written treatment plan that follows generally accepted national professional or governmental guidelines.

This requirement does not apply for patients who are being treated for cancer that is not in remission, in hospice or end of life care, or whose pain is being treated as part of palliative care practices. MSSNY took no position on this measure as it was consistent with the CDC’s Chronic Pain guidelines, and was an improvement from an earlier version that would have required a written treatment plan for pain lasting longer than 30 days. A copy of the letter from BNE is here. Information on the CDC’s Chronic Pain Guidelines is here. (CLANCY)


Medical Jobs Ad

NYS DOH Issues Emergency Regulations On PTSD, Substance Abuse And Opioid Use Disorder
This week the NYS DOH re-issued emergency regulations adding PTSD, substance abuse and opioid use disorder to the list of conditions to be treated by marijuana consistent with statutes enacted in 2018 authorizing medical marijuana to treat these conditions. DOH had previously issued an emergency regulation on this subject last October.

MSSNY has opposed adding these conditions to the list of medical conditions that a physician and/or other health care provider can certify a patient for use of marijuana.  However, importantly, these updated emergency regulations now require that any provider making a recommendation for marijuana for the treatment of opioid use disorder must have a DATA 2000 waiver. This regulation appears to limit when marijuana can be used and assures that only those who have appropriate training can make the decision.  A copy of the emergency regulations can be found on pages 7-9 at the NYS State Register 

MSSNY remains concerned about using marijuana for substance or opioid use disorders.  A recent JAMA article highlights the concern of substituting marijuana in place of buprenorphine. The Jama article concluded “For the opioid addiction crisis, clearly efficacious medications such as methadone and buprenorphine are under prescribed. Without convincing evidence of efficacy of cannabis for this indication, it would be irresponsible for medicine to exacerbate this problem by encouraging patients with opioid addiction to stop taking these medications and to rely instead on unproven cannabis treatment.  (CLANCY)


CPH Banner

Galef Introduces Legislation To Enable Greater Communication Between Physicians & Patients
Assemblywoman Sandy Galef has introduced legislation (A5909) that would exclude a statement by a physician indicating apology or regret as an admission of liability in malpractice lawsuits. Under current law, physicians open themselves up to malpractice liability if and when they express their condolences to patients and/or their families when there is a negative medical outcome – even if there has been absolutely no wrongdoing on the physician’s behalf.

At least thirty-six states have passed similar legislation. Enactment of this measure would allow physicians to provide the apology or validation that families and patients often state they hope for by preventing these statements from being used as admissions of guilt in legal proceedings. Further, research has shown that in those states with apology laws, malpractice cases are solved 20% faster and average claims payment amounts are lower.  (AVELLA)


Registration Now Open For Veterans Matters CME Webinars February 28th and March 14th
The Medical Society of the State of New York is proud to announce two NEW Veterans Matters webinars scheduled for February and March 2019. These webinars are: The Special Mental Health Needs of Women Veterans on Thursday, February 28th at 7:30am and Military Culture: Everything Physicians Need to Know About Veterans as Patients on March 14th at 7:30am.

Veterans Matters: The Special Mental Health Needs of Women Veterans
When:  Thursday February 28, 2019 at 7:30am – Register here
Faculty: Col. Malene Ingram, MD (US Army Reserves)

Educational Objectives: 

  1. Review how the increased role of women in the military has impacted their mental health.
  2. Describe mental health concerns unique to women veterans and how to identify and treat them.
  3. Identify the barriers that women veterans face in getting the specific care they need.

Veterans Matters: Military Culture: Everything Physicians Need to Know About Veterans as Patients
When: Thursday, March 14 2019 at 7:30am – Register here
Faculty: Lt. Col Lance Allen Wang, & Marcelle Leis, CM Sgt (Ret)

Educational Objectives 

  1. Describe the unique aspects of military culture and how they impact patients who are veterans.
  2. Explain the Dwyer Peer-to-Peer program as a resource to assist veteran patients re-acclimating from a group to an individual mentality.
  3. Review and identify resources to improve physician’s ability to fully treat veterans who are transitioning back into civilian life.

Additional information or assistance with registration can be obtained by contacting Sarah Humes at shumes@mssny.org or (518)465-8085

The Medical Society of the State of New York is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.

The Medical Society of the State of New York designates this live activity for a maximum of 1.0 AMA/PRA Category 1 credits.  Physicians should claim only the credit commensurate with the extent of their participation in the activity. (HUMES, HOFFMAN)


NY Rx Card Banner


Registration Now Open For Medical Matters: Disaster Medicine: Every Physician’s Second Specialty on March 27th at 7:30 am

The Medical Society of the State of New York will conduct a webinar entitled, “Disaster Medicine: Every Physician’s Second Specialty” on March 27, 2019 @ 7:30am.

Register now for:

Medical Matters: Disaster Medicine: Every Physician’s Second Specialty
Wednesday, March 27th @ 7:30am
Register Here
Faculty: Lorraine Giordano, MD, FACEP, FAADM

Educational Objectives:

  • Identify core preparedness competencies every physician should know
  • Explore essential elements of preparedness plans for staff, patients, and family
  • Describe available courses, resources and organizations to obtain disaster preparedness education and training

The Medical Society of the State of New York is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians. 

The Medical Society of the State of New York designates this live activity for a maximum of 1.0 AMA/PRA Category 1 credits™.  Physicians should claim only the credit commensurate with the extent of their participation in the activity.(HOFFMAN, CLANCY)


For more information relating to any of the above articles, please contact the appropriate contributing staff member at the following email addresses:

pschuh@mssny.org mauster@mssny.org  pclancy@mssny.org  mavella@mssny.org
charring@mssny.org

Garfunkel Ad


eNews

Dr. Ardis Hoven’s Two Grandchildren Killed in Car Accident in Lexington KY
Dr. Ardis D. Hoven, an AMA Past President and Chair of the Board, a friend of MSSNY and a friend of Dr. Madejski, lost her two grandchildren, 17 year-old Neo and 15 year-old Roan, in a car accident on Sunday morning in Lexington, Kentucky, Ardis’ hometown.  Please keep Dr. Hoven and her family in your thoughts and prayers.


FDA Head Warns Feds May Intervene if States Don’t Strengthen Vaccine Laws
FDA commissioner Scott Gottlieb said that the federal government may have to take action if states don’t strengthen their laws on vaccine exemptions, CNN reports.

Seventeen states allow families to choose not to vaccinate their children based on personal beliefs. Forty-seven states allow religious exemptions.

Measles outbreaks in the U.S. have infected 127 people so far in 2019; most were unvaccinated.


NYU to Offer Free Tuition to NYU Winthrop, a LI Medical School
New York University said Tuesday that its new three-year medical school on the campus of NYU Winthrop Hospital in Mineola will offer free tuition, matching the commitment made at its Manhattan campus. The university said it received preliminary accreditation from the Liaison Committee on Medical Education on Feb. 12 and plans to recruit its first students, to start in July.

The timing differs from most medical schools, which already may be delivering decisions to applicants. But Dr. Steven Shelov, dean of the NYU Long Island School of Medicine, said he still expects the school’s tuition-free program to draw thousands of applicants for its 24 initial slots. That number eventually will rise to 40 students per class.

For students to graduate in three years, the medical school will cut certain activities, such as weeks-long periods that allow students to travel to interview for residency programs and independently study for board exams. Instead, students will have conditional acceptance to primary care residency programs at NYU Winthrop, and group study for licensure exams will be part of the curriculum.

Preference for admission will be given to students who say they will train and practice in the New York metro area, the school said. Students who want to apply to residencies in other locations will be allowed to do so, but Shelov said he expects those students to be exceptions. The school tailored the curriculum for a career in primary care, with less focus on topics that would be applicable to future physician scientists and subspecialists. (Crains, 2/20)


Have You Seen an Increase in Automatic Down Coding of Your Visit Codes?
MSSNY has heard from a few members that they have been subjected to automatic down coding of their evaluation and management visit codes.  Has this affected you or your practice?  If so, please send an email to Regina McNally.  Please use DOWN CODING in the subject line.  Do not include any patient information; but do include the plan name, the code you billed and the code the plan reduced it to.  In addition, please let us know if you filed an appeal with a copy of the medical record and what the result was, if any.  Send your email to at rmcnally@mssny.org.


Physicians Have Concerns about Legalized Recreational Marijuana
New York physicians still have “significant concerns” with the executive budget proposal to legalize recreational marijuana, says Dr. Thomas Madejski, president of the Medical Society of the State of New York.

In a statement released Feb. 15, Madejski said that although a recent legislative public hearing “provided valuable insight,” there are several questions that need to be answered to alleviate physicians’ concerns, including how to keep marijuana out of children’s hands, especially as youth are using e-cigarettes are at an unprecedented pace. “The recently announced report from the CDC that 2018 saw the largest single-year increase in youth tobacco ever recorded—driven by adolescents who reported using e-cigarettes—is alarming,” Madejski said. “How will we ensure that legally purchased cannabis doesn’t get into the hands of children, similar to e-cigarettes?”

He said physicians also are concerned about a possible increase in drugged driving as a danger to pedestrians and other drivers. Madejski called for the continued review of data on public health implications from other states that have legalized marijuana and more research on the efficacy of marijuana for treating a range of health conditions. “We look forward to continued constructive discussion with the Legislature and the governor’s office on this issue,” he said. —Crains 2/19.


Sexual Harassment “Train the Trainer” FREE Webinar on March 20 at 12 noon
The Impact on the Healthcare System and the Medical Profession

When: March 20, 2019
Time:  12:00pm-1:00pm

REGISTER HERE

The issue of sexual harassment in the workplace has been the center of a staggering amount of media attention and of a surge in litigation activity. Consistent with this momentum, New York State recently mandated that all employers are required to have a sexual harassment policy containing specified criteria in place by October 9, 2018, and to conduct sexual harassment prevention training by October 2019. (New York City requirements are slated to take effect in April 2019.)

The issue of sexual harassment takes on particular significance for the healthcare industry, because there is an established nexus between disruptive behavior, which includes sexual harassment, and adverse patient outcomes and medical errors. For those individuals who are unable to participate in the webinar at that time, MSSNY will be placing a recorded version of that webinar on the MSSNY website to facilitate access to the webinar for MSSNY members.

By the conclusion of the “Train the Trainers” webinar, you will know how to teach your employees:

  • How to identify the more subtle forms of sexual harassment.
  • The impact of sexual harassment on the quality of care and the victim.
  • Practical advice on how to diminish and prevent sexual harassment at your practice.
  • How to respond to sexual harassment in the workplace.
  • Guidelines on how to comply with statutory mandates relating to sexual harassment.

Garfunkel Wild offers individual or group training, on-site or off-site training, as well as webinar modules that can serve to satisfy this new statutory mandate for your employees. If you would like to set up a personal training, please contact Andrew L. Zwerling at 516-393-2581 or azwerling@garfunkelwild.com.


Extortion Scam Targeting DEA Registrants
DEA is aware that registrants are receiving telephone calls and emails by criminals identifying themselves as DEA employees or other law enforcement personnel.  The criminals have masked their telephone number on caller ID by showing the DEA Registration Support 800 number.  Please be aware that a DEA employee would not contact a registrant and demand money or threaten to suspend a registrant’s DEA registration.

If you are contacted by a person purporting to work for DEA and seeking money or threatening to suspend your DEA registration, submit the information through “Extortion Scam Online Reporting” posted on the DEA Diversion Control Division’s website, Extortion Scam Online Reporting

For more information contact:
Locate DEA Field Office for your area – https://apps.deadiversion.usdoj.gov/contactDea/spring/fullSearch
Registration Service Center – 1-800-882-9539
Email – DEA.Registration.Help@usdoj.gov


Physician Employment, Acquisition of Physician Practices Continue to Increase
A new study by PAI analyzes eighteen months of data – between July 2016 and January 2018 – during which hospitals acquired 8,000 medical practices, and an additional 14,000 physicians left private practice in favor of employment. This continued an ongoing trend that earlier PAI-Avalere research documented for the period between July 2012-July 2016, which witnessed an intense increase in hospital acquisitions and growth in physician employment.

The cumulative study period – from July 2012 through January 2018 – saw a dramatic, sustained trend of physicians leaving independent practice to enter into employment arrangements with hospitals and health systems. Over the full 5 ½- year study period, the number of hospital-acquired physician practices increased from 35,700 in 2012 to more than 80,000 in 2018. Forty-four percent of U.S. physicians were employed by hospitals or health systems by January 2018, compared to just one in four in July 2012.

These latest cumulative findings highlight striking changes in health care delivery, marked by consolidation between the hospital and physician sectors in every region of the country.

  • Throughout this period, hospitals aggressively pursued acquisitions of physician practices, growing from 35,700 hospital-owned practices in July 2012 to 80,000 in January 2018. This 128 percent growth represents more than doubling in the number of hospital-owned practices nationwide.
  • Physician employment increased overall by more than 70 percent, growing from 94,700 employed physicians in mid-2012 to 168,800 employed physicians in January 2018, with increases in every six-month time period measured over five-and-a-half years.
  • All regions of the United States saw an increase in hospital-owned practices, with a range of total increase from 91 percent to 303 percent by region.

New Resources for 2019 Program Year for Promoting Interoperability Programs
CMS is currently updating the Promoting Interoperability Programs website to include new resources for the 2019 program year. Below are resources that are now available online:

For More Information

For more information on the Promoting Interoperability Program reporting requirements for 2019, please visit the Promoting Interoperability Programs website. Additional information for the Medicare and Medicaid Promoting Interoperability Programs for 2019 will be posted on the Promoting Interoperability Programs website in the coming weeks.


Two Programs at the HOD You Don’t Want to Miss!
Protect Your Patients, Your Practice, and You!

Thursday, April 11, 2019, 3:00 – 4:00 pm, Grand Ballroom D/E, Westchester Marriott, Tarrytown

Join us at the OMSS Annual Meeting for an interactive presentation by Garfunkel Wild on Medical Records, including the impact on records of the controlled substances “epidemic,” what to consider when emailing and texting, dealing with non-compliant patients, additional areas of exposure from EMRs, and what to include in a telemedicine record.

Business meeting to follow, 4:00 – 6:00, Putnam Room

Click here to view flyer.

Women in Medicine: Reaching Your Potential Now!

Friday, April 12, 2019, 5:00 – 6:30 pm, Grand Ballroom B, Westchester Marriott, Tarrytown

A panel presentation at the Women Physicians Caucus on Pay, Promotions and Career Advancement in Academic Medicine, Private Practice and Organized Medicine. Gender imbalance in medicine and academic sciences still exists. Hear three women physicians who have achieved significant leadership positions describe their own pathways, provide advice on how to achieve success, and show how to overcome gender bias, gender pay gaps and system-wide barriers to career advancement. Learn how to achieve success in your career!

Click here to view flyer.

Register for one or both programs at sbennett@mssny.org.


Doctors Without Borders: Put Your Ideals into Practice!
On Thursday, March 14th, 2019 you are invited to join Doctors Without Borders/Médecins Sans Frontières (MSF) for a recruitment information session in the Bronx, NY. This is your opportunity to meet our recruitment team and learn about how you can join our pool of dedicated aid workers. We’re currently recruiting for a variety of medical and non-medical positions. Register here.


Study: Lower Mortality Rates Associated With Greater Number of Physicians
Reuters (2/18) reports that “mortality rates are lower in American communities with more primary care physicians than in areas of the country with fewer doctors, a study suggests.

The “number of primary care physicians rose from 196,014 in 2005 to 204,419 in 2015, the study found.” However, “because of disproportionate losses of providers in rural areas, the average number of primary care physicians for every 100,000 people in the population declined from 46.6 to 41.1 during the same period.” Further, “each 10 additional primary care physician per 100,000 people was associated with a 51.5 day increase in life expectancy, the study also found.” The study was published in JAMA Internal Medicine.


September 11th Compensation Fund Running Low on Money
The AP (2/16) reported that “the compensation fund for victims of 9/11 is running out of money and will cut future payments by 50 to 70 percent, officials announced Friday.” Almost “40,000 people have applied to” the September 11th Victim Compensation Fund, a “federal fund for people with illnesses potentially related to being at the World Trade Center site, the Pentagon or Shanksville, Pennsylvania, after the 2001 terror attacks there, and about 19,000 of those claims are pending.” Almost $5 billion of the $7.3 billion fund has already been awarded, but “fund officials estimate it would take another $5 billion to pay pending claims and the claims that officials anticipate will be submitted before the fund’s December 2020 deadline.


“Im/Migrant Workers Conference: Health Barriers and Solutions” at University of Rochester
University of Rochester School of Medicine, Flaum Auditorium
This Saturday 2/23/19, 9am-3pm

Ticket Pricing
Student Registration: Free
General Public: $5.00
CME credit (4.5 credits): $13.00

Register herehttps://urmcimmigrantworkerconference.brownpapertickets.com

Registration fee inclusive of breakfast & lunch.

Conference Website: https://ursmdmwc.wordpress.com


 

Classified

RENTAL/LEASING SPACE

Office Rental 30 Central Park South.
Two fully equipped exam, two certified operating, bathrooms and consultation room.  Shared secretarial and waiting rooms. Elegantly decorated, central a/c, hardwood floors. Next to Park Lane and Plaza hotels. $1250 for four days a month. Available full or part-time. 212.371.0468drdese@gmail.com.


5th Ave Medical Office for Share
Facing Central Park in exclusive building, ground floor, separate entrance.
Perfect for psychiatrist, physiatrist, osteopath, or other.
880 5th Avenue (between 69th and 70th Sts.), New York, N.Y.
Please call 917-715-2464


Rare Find — Great Office Share
Wonderful office share in terrific location at great price. Available Monday, Wednesday, Friday and weekends. Choice of smaller windowed consultation room with adjoining exam room or big windowed consultation room with one or two exam rooms. Beautiful bright rooms, lovely reception area and front . First-rate building on 58th Street between Park and Lexington. Rent by day (about $180). Front desk and office management available if needed, along with many other amenities, including internet, ultrasound, EMG Kitchen, optional C Arm. Willing to make changes for new tenant. Call 646-642-0700.


Are You Trying to Lease Your Medical Office or Sell Your Medical Practice? Trying to Sell New or Used Medical Equipment?
Clineeds, the new online platform designed for medical providers. With Clineeds you can lease your medical officeshared your office spacebuy and sell used medical equipment, or post healthcare job opportunities. LISTING IS FREE! Why wait? Click here to sign-up: www.clineeds.com/sign-up


PHYSICIAN OPPORTUNITIES

Pediatrician BC, P/T
Seeking motivated, enthusiastic pediatrician for P/T position in solo practice in Long Island. Coverage will increase over time. Great opportunity for those seeking part time hours in an established practice.   Fax resume to 516-858-2389.


Physician Wanted to Help Shape the Future of Primary Care
98point6 is a healthcare technology company committed to delivering more affordable, accessible, high-quality primary care. To support our mission, the insights of forward-thinking physicians like you are invaluable. Members of our exclusive Primary Care Council have no clinical responsibilities and are generally compensated for participation, which requires only a few hours per year.

Interested? Learn more and apply today at www.98point6.com/pcc



CALL FOR RATES & INFO. CHRISTINA SOUTHARD: 516-488-6100 ext. 355

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 


MSSNY Statement on Legalization of Cannabis Public Hearing


MSSNY Seal
MEDICAL SOCIETY OF THE STATE OF NEW YORK
865 Merrick Avenue, Westbury, New York 11590-9007
www.mssny.org
Communications Division
Telephone: (516) 488-6100

 

 

February 15, 2019
For Immediate Release

MSSNY Statement on Legalization of Cannabis Public Hearing

Statement attributable to:
Thomas Madejski, MD
President, Medical Society of the State of New York

“Wednesday’s legislative public hearing on legalization of cannabis provided valuable insight into the comprehensive Executive Budget proposal to enable the legalization of “adult use” or “recreational” marijuana.  Importantly, Governor Cuomo’s staff emphasized the need for significant funding to be allocated for education and public health awareness campaigns to prevent inappropriate use.  We note that the Budget proposal contains strict advertising restrictions.

However, the discussion has not eased the significant concerns with this proposal within New York’s physician community.  The recently announced report from the CDC that 2018 saw the largest single-year increase in youth tobacco ever recorded—driven by adolescents who reported using e-cigarettes—is alarming. How will we ensure that legally purchased cannabis doesn’t get into the hands of children, similar to e-cigarettes?  What measures will be taken to prevent a person from stockpiling marijuana from multiple dispensaries, and then reselling it illegally? We are urging caution, and anticipation by which these proposed laws could be evaded.

Furthermore, we continue to be very concerned about the possibility of significantly increased drugged driving, threatening pedestrians and other drivers.  Of particular concern is that the ability for law enforcement to detect marijuana use while driving is tenuous at best, with no reliable breathalyzer or on-the-scene testing tool yet available.

We must continue to carefully review data from states that have legalized marijuana regarding the public health implications for its residents.  Moreover, we need more research into the efficacy of marijuana for treating a multitude of health conditions faced by our patients, which is why we are supportive of efforts to require the federal Drug Enforcement Administration (DEA) to re-classify marijuana out of Schedule 1 (which means no medicinal benefit).

We look forward to continued constructive discussion with the Legislature and the Governor’s office on this issue.”

# # #

About the Medical Society of the State of New York
Founded in 1807, the Medical Society of the State of New York is the state’s principal non-profit professional organization for physicians, residents and medical students of all specialties. Its mission is to represent the interests of patients and physicians to assure quality healthcare services for all.

Media Contact:
Roseann Raia

Medical Society of the State of New York
865 Merrick Ave.
Westbury, New York
516.488.6100 x 302
rraia@mssny.org

 

February 15, 2019 – Common & Uncommon Denominators

Thomas J. Madejski, MD MSSNY President
PRESIDENT’S MESSAGE
Thomas J. Madejski, MD
MSSNY President


MSSNY eNews
February 15, 2019
Volume 22  Number 7

MSSNYPAC Seal

Colleagues:

I have alluded to the confluence of information streams and activities that surrounds and runs through all of our lives. Last Saturday, I was honored to join our students, residents, fellows and MSSNY Young Physician members.  Immediate Past President Charles Rothberg, President Elect Art Fougner, and Vice President Bonnie Litvack also participated enthusiastically in discussions.  We were impressed by the thoughtfulness and maturity of our younger colleagues—they seemed to be smarter, better organized, and more committed to improving the lives of our patients and the practice of medicine than either of us were at a comparable age.  That should give us encouragement and great optimism for the care of our patients and the future of our profession!

Within 60-90 minutes, a number of data points swirled around me:

  • Joe Sellers, our MSSNYPAC Chair, gave a presentation on advocacy and the political process. He used the current measles outbreak in multiple areas in New York and 9 other states to demonstrate the importance of our policy development and advocacy activity to protect our citizens and improve the public health.
  • A number of resolutions were discussed for submission to the MSSNY House of Delegates. Second year medical student, Connor Sholtis, worked with University of Rochester MSS representatives Shireen Saxena, Randall Porter and other U of R students created a resolution that looks to reduce barriers to mental health care for medical students.  I believe this has the potential to begin to change our approach to student and physician stressors and improve physician wellness.
  • Carlos Zapata, YPS Councilor, moderated a social media discussion/ work session.
  • While participating in the social media workshop, I received a tweet that Ron Wyden (D-Ore.) had introduced legislation that would legalize marijuana at the federal level, designating the measure S. 420 in a nod to cannabis culture. The proposal, identical to a bill in the House, aims to ease the longstanding conflict between states where cannabis is legal in some form and the U.S. government, which categorizes marijuana as a dangerous illegal drug, similar to LSD or heroin.

I have to say the MSSNY presidency forces you to look for themes and common denominators that bring policy together to make our advocacy more effective.  The common denominator in all of this is what we in medicine do best— apply the science informing an issue to our patients and our communities.  The students gathered evidence relating to effective interventions for depression and applied it to their particular community.   Dr. Sellers reviewed the evidence for interventions to increase vaccinations and MSSNYs approach to counter pseudoscience that has caused a drop off in vaccination rates and immunity leading to a recrudescence of a preventable, potentially eradicable disease.

Personally, I look forward to discussing movement of marijuana to Schedule II with our federal representatives to allow the research needed to clear the smoky haze surrounding a complex psychoactive substance and define its proper place in the pharmacopoeia.

Our legislators have impressed me over many years with their knowledge of the many different subjects under legislative consideration. They rely on us to give them specific, evidence-based information about how legislative proposals effect our patients and their constituents. As Adam Smith opined, “Science is the great antidote to the poison of enthusiasm and superstition.”

Are You Coming or Not?

Come with me to Albany March 6th to help provide crucial information about the many issues effecting the citizens of New York State.  A few counties are providing bus transportation—call your county executive for information! Your colleagues, your patients, and our fellow citizens are depending on us.

Never be afraid to raise your voice for honesty and truth and compassion against injustice and lying and greed- William Faulkner

Comments? comments@mssny.org; @mssnytweet; @TomMadejski

Thomas J. Madejski, MD
MSSNY President



MLMIC Insurance Banner


Capital Update

SAVE THE DATE: MSSNY’s Annual “Physician Advocacy Day” (3/6)!
With nearly 40 newly elected legislators in Albany, the need for physician advocacy and grassroots involvement is greater than ever. With so much new representation, it’s vital for physicians to forge new relationships, and to strengthen existing relationships to ensure the physician community’s message about policies that could impact patient care is heard.

One opportunity is to participate in MSSNY’s “Physician Advocacy Day” that will be held on Wednesday, March 6th in the Lewis Swyer Theatre in the Egg located at the Empire State Plaza, Albany NY. Click here to register!

Join your colleagues from all around New York State and come to MSSNY’s Physician Advocacy Day to speak with your legislators and key policymakers to ensure they’re making the right choices for New York’s physicians and their patients.

Join us to urge your legislators to:

  • Proceed very cautiously on paradigm shifting proposals such as legalization of recreational marijuana (proposed in the State Budget) and creating a single payor health insurance structure;
  • Reject the $80/per patient cut to physicians treating patients covered by both Medicare and Medicaid;
  • Reject proposals that would add prior authorization burdens for care provided to Medicaid patients;
  • Support legislation to reduce excessive health insurer prior authorization hassles that delay patient care;
  • Reduce the high cost of medical liability insurance through comprehensive reforms;
  • Preserve opportunities for medical students and residents to become New York’s future health care leaders.

The morning program will be followed by a brief and informal luncheon to which members of each House are invited to speak with their constituents.  County medical societies will be scheduling afternoon appointments for physicians to meet with their elected representatives.

If you have any questions/comments, please contact Carrie Harring at charring@mssny.org.                                           (HARRING)


MSSNY Physician Leaders Advocate for Their Profession and Their Patients in the Nation’s Capitol
Several MSSNY physician leaders and staff members traveled to Washington, DC this week for meetings with many New York Congressional representatives.  Physicians advocated for several measures to improve and preserve patient access to needed physician care, including:

  • Assuring that any “surprise medical bill” law enacted on the federal level is consistent with New York’s comprehensive law which has become a model for the country;
  • Preserving seniors’ access to needed care through increases to the Medicare fee schedule to keep up with practice cost inflation;
  • Reducing the hassle factor associated with participation in the Medicare MIPS program and assuring EHR interoperability;
  • Lifting the DEA Schedule 1 classification of marijuana so that necessary research can be performed on potential medicinal benefits.

Among the attendees were the following: MSSNY President and Medina internist Dr. Tom Madejski; MSSNY Immediate Past-President and Long Island ophthalmologist Dr. Charles Rothberg; former MSSNY Councilor and Schenectady ophthalmologist Dr. John Kennedy; Erie County Medical Society Past-President, AMA Council on Legislation Chair and Roswell Park urologist Dr. Willie Underwood;  MSSNY Councilor and Queens Emergency Department Physician Dr. Carlos Zapata; MSSNY Legislative & Physician Advocacy Committee Vice-Chair Dr. Rose Berkun, Oswego Family practice physician Dr. Corliss Varnum; medical student Usman Aslam; and MSSNY staff.

The meetings occurred in conjunction with the American Medical Association’s annual National Advocacy Conference, where physicians across the country go to Washington to meet with their respective members of Congress.                                                                                 (AUSTER)


 

State Lobby Day Banner


Governor Releases Budget Amendments that Includes Across the Board Medicaid Payment Cut
Today Governor Cuomo gave to the Legislature his “30-day amendments” to his Executive Budget proposal that was formally introduced on January 15. While staff is continuing to review the entire proposal, of concern is a proposal that would impose an across the Board Medicaid cut to all covered Medicaid providers totaling $190 million.  Spending under the Medicaid global cap for FY 2020 is expected to be $19.4 billion. This could translate to a material per service cut (exact amount to be determined) to physicians and other health care providers.  Please remain alert for further update on this issue.                                                      (AUSTER)


Legislators Advance Legislation Aimed at Preventing Maternal Deaths
Legislation (S.1819, Rivera/A.3276, Joyner) advanced this week from the Senate Women’s Issues Committee, and from the Assembly Health and Codes Committees, that would establish maternal mortality review boards and the maternal mortality and morbidity advisory councils for New York State and New York City.  The goal of S1819/A3276 is to gather and review information related to maternal deaths and illness, to disseminate their findings and to develop recommendations and best practices to improve maternal health in New York.

The legislation also provides needed confidentiality protections regarding the board’s proceedings and requires the Board to report on its aggregate finding and recommendations.  MSSNY working together with the American College of Obstetricians & Gynecologists (ACOG) is in support of this legislation and strongly backs its goal of improving health outcomes in New York.      (AVELLA, CLANCY)


Medical Jobs Ad

Physicians Urged to Oppose $80/Dual Eligible Patient Cut
All physicians are urged to contact their state legislators to urge that they reject a proposal contained in the 2019-20 Executive Budget that would significantly cut the payments that Medicaid makes to physicians to cover the Medicare Part B deductibles of their “dually eligible” patients.   You can send a letter in opposition by clicking here.

You can read MSSNY’s memo of opposition to the Legislature here.

While the exact cut for each physician would depend on the physician’s patient mix and services provided, we estimate that the cut would be $80 per patient.  That is because the 2019 Medicare Part B deductible is $185, and studies show that on average Medicaid only pays 56% of the Medicare fee schedule in New York.

Given that there are hundreds of thousands of patients in New York who are “dually eligible”, practices that see a large number of dual eligible patients be profoundly impacted.  For example, if a physician’s patient mix includes 500 such dual eligible patients – which could certainly be the case for many types of specialty physicians – that amounts to a decrease of over $40,000 per year – funds that could go toward upgrading electronic health records, hiring additional staff to allow for more time with patients, upgrading facilities or other medical equipment. In past years, physicians have had to absorb significant cuts from Medicaid for the care that they provide to their senior and disabled patients covered by both Medicare and Medicaid, making it much harder for these physicians to deliver community-based care. Please urge your legislators know how unfair this cut is.  Please urge them to oppose balancing the state budget on the backs of dedicated community physicians seeking to deliver quality care to their patient.        (AUSTER)


Governor’s Staff Testifies Before Legislative Body Regarding Cannabis Regulation and Taxation Act
On Wednesday 2/13, Governor Cuomo’s staff testified to members of the Senate and Assembly at a public hearing regarding the legalization of adult-use of cannabis. The governor’s administration was represented by Alphonso David, Counsel to the Governor; Axel Bernabe, Associate Counsel for Health; Jason Starr, Assistant Counsel; Jen McCormick, First Deputy Commissioner of the Department of Agriculture and Markets; and Dr. Chinazo Cunningham, member of faculty at the Albert Einstein College of Medicine and a member of the Governor’s Workgroup on Cannabis Regulation.

Mr. David, supported by his staff, provided an outline of the plan in this year’s budget proposal and addressed a large list of questions and concerns raised by members of the legislature. He described their approach as “integrated” and discussed the three separate markets (adult-use, medical and hemp).

Questions from state representatives focused on how regulation would be structured, how communities would be impacted, how law enforcement officials would manage driving, use, sale, etc. and what the economic implications would be. Of note were questions about the ability to test for impaired driving and how to prevent legally purchased cannabis from getting into the hands of minors. Mr. David and staff acknowledged that some of the aspects of this program are still being worked out and would require further research and discussion.

A copy of David’s testimony can be found here.

The hearing can be watched here.      

This week MSSNY President Dr. Tom Madejski was quoted in an article that highlighted the diverse array of groups – Doctors, Parents, Mental Health Advocates and Police – that have raised concerns with proposals to legalize “adult use” or recreational marijuana use.  A copy of the article can be found here.

Dr. Madejski also issued the following statement which can be found here regarding the discussion at the Cannabis hearing that praised the efforts of the Administration proposal to assure necessary public education regarding cannabis use, but continuing to raise concerns about diversion to youth and the potential increase in drugged driving.                                                              (AVELLA, CLANCY)


CPH Banner

Your Help is Requested to Complete the SHIN-NY Customer Satisfaction and Usage Survey
NORC at the University of Chicago, an independent non-profit research organization, is administering a web survey designed to assess user experiences with health information exchange services offered by New York’s Qualified Entities (QEs).  The results of this survey will be used to improve health information exchange services provided by New York’s Qualified Entities and the Statewide Health Information Network of New York (SHIN-NY).

The survey asks about how an organization uses specific clinical data exchange services provided by New York’s eight QEs in care delivery. Questions also focus on the level of satisfaction with the different QE services as well as any challenges around the use of the services.

The New York eHealth Collaborative (NYeC) is asking physicians that receive a mail or email invitation to participate in the survey as soon as possible. After completing this brief online survey, respondents will receive a gift code or can donate their gift to a charitable organization.

For more information or if you have any questions, please contact the NORC at the University of Chicago team at SHIN-NY@norc.org or call them at 1-800-975-2754.  (AUSTER)


NYS Senate and NYS Assembly Advance Bill Mandating Patient Education for C-Section; Physician Action Urged
Senate Bill 2888/A.318, sponsored by Senator Julia Salazar and Assemblymember Amy Paulin, has advanced to the Senate calendar after being reported from the Senate Women’s Issues Committee this week by a 4-2 vote with one additional Senator voting without recommendation. 

The measure would require all physicians and other health care providers to provide all maternity patients with written information as to the risks associated with Cesarean section. This measure has already passed the NY State Assembly. The Medical Society of the State of New York & ACOG are opposed to this measure as it interferes with the physician patient relationship by requiring a written communication to every single pregnant women whom the physician recommends a  C-Section. MSSNY, the NYS Academy of Family Physicians & ACOG are concerned that an individual patient may have different risk factors and health needs.  Furthermore, the terminology of the bill is not consistent with the typical medical practice. 

The Medical Society is also troubled by the proliferation here in New York State, and nationally, calling for legislation requiring educational information that physicians will need to cite that pertains to women’s health issues.  Nationally, a disproportionate number of these bills apply only to physicians when they are treating pregnant women.  Furthermore, states have gagged or coerced physician communications for politicized public health issues.   This measure mandates physicians to provide “a script” that may not comply with the latest medical evidence on Cesarean section.  Physicians are urged to contact their Senate members and urge defeat of the bill.  Senate members can be reached through the main senate switchboard at (518) 455-2800 or by sending a letter through the MSSNY Grassroots Action Center here.                     (CLANCY)   


NY Rx Card Banner


MSSNY Seeking Information on NYS Physicians Having Difficulties with Walmart on Prescribing Practices
The Medical Society of the State of New York is interested in hearing from physicians who may have received a letter from Walmart in regards to the prescribing practices for controlled substances.   Walmart, Walgreens, and CVS pharmacies have implemented the CDC Guidelines for Prescribing Opioids for Chronic Pain as corporate policy.  MSSNY has learned that Walmart has sent letters to physicians throughout the country about their prescribing practices.   In the letters, Walmart indicated that it will no longer be accepting physicians’ prescriptions for Controlled Substances II-V after Walmart’s review of a physician’s prescribing practice.

MSSNY is extremely concerned about corporate policies that could result in refusal to fill prescriptions above certain doses and to refuse to fill prescriptions from certain physicians based on the corporation’s arbitrary definitions of questionable prescribing patterns.  MSSNY is aware that a few NYS physicians have received this letter and several physicians have been told by Walmart that it will not honor any prescription for Controlled Substance II-V.   MSSNY has brought this matter to the attention of the NYS DOH Bureau of Narcotics and is awaiting further information from them.   In particular, we have raised concerns that such policies could result in patients unfairly being denied access to needed medication.  Any physician who may have received this letter, please contact Pat Clancy, Sr. Vice President, Public Health and Education/Managing Director, at pclancy@mssny.org or by phone at 518-465-8085.            (CLANCY)


Physician’s Electronic Emergency Preparedness Toolkit Updated
Be sure to check out MSSNY’s newly updated Physician’s Electronic Emergency Preparedness Toolkit at the MSSNY CME website.  This essential toolkit is set up in four modules and provides participants with a total of 15 free CME credits.  Each module offers a comprehensive selection of resources on everything from legal protections and best practices to go-bag and office checklists.  MSSNY designed this resource to assist medical professionals in becoming fully prepared and ready for the next public health emergency.  MSSNY has also created a new podcast to accompany the updated toolkit, be sure to listen to it here.                 (HOFFMAN, CLANCY)


“What’s Your Diagnosis? Psychological First Aid” Interactive CME Webinar
Be sure to register for the next Medical Matters webinar, What’s Your Diagnosis? Psychological First Aid.  This program will involve more interaction from participants.  You will be asked to answer questions about a case and discussion will follow.  Find out if you’re fully prepared to include psychological first aid during an emergency on February 20th at 7:30am.  Registration is open for this program here. Faculty will be Craig Katz, MD, co-vice chair of MSSNY’s Emergency Preparedness and Disaster/Terrorism Response Committee.

Educational Objectives:

  • Describe the basic tenets of psychological first aid (PFA)
  • Identify resources to assist patients during and after trauma
  • Describe a scenario and review questions and answers

The Medical Society of the State of New York is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.

The Medical Society of the State of New York designates this live activity for a maximum of 1.0 AMA/PRA Category 1 credits™.  Physicians should claim only the credit commensurate with the extent of their participation in the activity. 

(HOFFMAN, CLANCY)


Registration Now Open for New Veterans Matters CME Webinars
The Medical Society of the State of New York is proud to announce two NEW Veterans Matters webinars scheduled for February and March 2019. These webinars are:

Veterans Matters: The Special Mental Health Needs of Women Veterans

When:  Thursday February 28, 2019 at 7:30am – Register here.

Faculty: Colonel Malene Ingram, MD, US Army Reserves

Educational Objectives:

  • Review how the increased role of women in the military has impacted their mental health.
  • Describe mental health concerns unique to women veterans and how to identify and treat them.
  • Identify the barriers that women veterans face in getting the specific care they need

Veterans Matters: Military Culture: Everything Physicians Need to Know About Veterans as Patients

When: Thursday, March 14 2019 at 7:30am – Register here.

Faculty: Lt. Col Lance Allen Wang, & Marcelle Leis, CM Sgt. (Ret)

Educational Objectives

  • Describe the unique aspects of military culture and how they impact patients who are veterans.
  • Explain the Dwyer Peer-to-Peer program as a resource to assist veteran patients re-acclimating from a group to an individual mentality.
  • Review and identify resources to improve physician’s ability to fully treat veterans who are transitioning back into civilian life.

Additional information or assistance with registration can be obtained by contacting Sarah Humes at shumes@mssny.org or (518)465-8085

The Medical Society of the State of New York is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.

The Medical Society of the State of New York designates this live activity for a maximum of 1.0 AMA/PRA Category 1 creditsä.  Physicians should claim only the credit commensurate with the extent of their participation in the activity.

 (HUMES, HOFFMAN)


For more information relating to any of the above articles, please contact the appropriate contributing staff member at the following email addresses:

pschuh@mssny.org mauster@mssny.org  pclancy@mssny.org  mavella@mssny.org
charring@mssny.org
eNews
MSSNY Physician leaders meet in Washington, DC with New York legislators to support efforts to assure patient access to care.

Senator Schumer

Dr. Willie Underwood; Dr. Corliss Varnum; Dr. Charles Rothberg; MSSNY President Dr. Tom Madejski; Senator Schumer; Dr. Carlos Zapata;  Medical Student Usman Aslam; and MSSNY Sr. VP Of Legislative Affairs Moe Auster

Dr. Corliss Varnum; Dr. Charles Rothberg; US Rep. Paul Tonko (20th Cong. District); MSSNY President Tom Madejski; MSSNY Senior VP Legislative Affairs Moe Auster; and Medical Student Usman Aslam

MSSNY EVP Phil Schuh  (second from left) joins the MSSNY contingency at US Rep. Morelle’s (25th District) office.

Dr. Rose Berkun (first on left) joined the group at US Rep. Elise Stefanik (21st District).

Update on ZocDoc Pricing Change
MSSNY and its General Counsel, Garfunkel Wild, P.C., met with representatives of Zocdoc to better understand the planned change in its pricing model, and to discuss concerns raised by MSSNY’s members. Zocdoc currently charges its customers a flat annual fee (with no booking fee), and is now moving to a substantially reduced annual fee, with an additional per new patient booking fee based on the physician specialty.

The new policy is effective April 1, 2019.  Zocdoc has received a legal opinion from the New York State Department of Health (based upon information provided by and a request from ZocDoc) advising that its new pricing model does not constitute an illegal referral business or fee splitting under New York law.  They are currently pursuing guidance from the federal government prior to implementing this new pricing plan for Medicaid and Medicare patients. MSSNY and Garfunkel Wild will continue to monitor the situation and keep all members appraised of any new developments. Members with questions can reach out to MSSNY ‘s Legal Counsel Garfunkel Wild, PC: Barry Cepelewicz (516-393-2725); Hayden Wool (516-393-2232); or James Dering (518-560-4021).


Recreational Marijuana: NY Police, Doctors and Educators Fight Legalization
New York’s recreational marijuana battle sits on the frontline of a generational war over American cannabis laws. As debate heats up, USA TODAY Network New York is compiling answers to key questions about legalized cannabis. The findings will be updated each Monday as New York considers joining the 10 states that allow adults to use marijuana.

A growing opposition movement across law enforcement, education and public health is attacking the politically charged push to legalize recreational marijuana in New York.

Many of the powerful advocacy groups suggest passage could lead to spikes in drugged driving and marijuana-related health risks ranging from smoking hazards to psychotic episodes.

LEGAL POT: Northeast states grapple with recreational marijuana bills in 2019 legislative sessions. Some warn New York’s sudden rush towards legal marijuana ignores how profit-driven corporations hooked generations of Americans on alcohol, cigarettes and opioids, killing millions and straining public resources.

“We have many different intoxicants in our society, none of them are particularly helpful, and I think adding one more is not in society’s interest,” said Dr. Thomas Madejski, president of the Medical Society of The State of New York. (Feb 15 Lohud Rockland/Westchester Journal News)


AMA Presented Prestigious Dr. Nathan Davis Award to MSSNY Member Richard “Doc” Izquierdo, M.D., for Outstanding Public Service
Dr. Izquierdo has served his Bronx community for nearly six decades as a physician, health care innovator, community leader and Medical Society advocate. Dr. Izquierdo was chosen for the AMA’s top public service award for his lifetime of work, serving generations of Bronx residents. The award was presented to Dr. Izquierdo at a ceremony in Washington, D.C. as part of the AMA’s National Advocacy Conference.

Dr. Izquierdo’s daughter, Paloma Izquierdo-Hernandez, was scheduled to accept the award on her father’s behalf but her flight was canceled due to inclement weather in New York. MSSNY President Dr. Madejski stepped in to accept the award on behalf of Dr. Izquierdo. Click here to view a video of Dr. Madejski accepting the award.



Garfunkel Ad


Women Are Overlooked, Undervalued in Healthcare, Research Suggests
A study by The Lancet publishing on Feb. 9 stated, “Women are overlooked by medical researchers and undervalued in health-related careers, a series of reports in the British medical journal the Lancet has found.”

The reports’ authors “found medical research was skewed toward the needs of men, with almost three quarters of biomedical research papers failing to consider differences in outcome according to sex.” One report indicated that “women outnumbered men at junior levels, but their numbers dwindled in senior posts.” A separate report “found women suffered from bias when applying for research funding.” he studies can be found here, here, and here.


CVS Unveils New HealthHub Store to “Manage” Chronic Conditions and Test Blood
CVS Health has unveiled three redesigned health-focused concept stores in the Houston market, according to CNBC. The pilot stores, called HealthHubs, have space for services to help customers manage such chronic conditions as diabetes, hypertension and asthma. Each store also has an expanded health clinic with a lab for blood testing and health screenings. Beyond those services, there are also wellness rooms equipped to handle yoga classes and seminars.

While the new stores have less space for greeting cards, seasonal items and general merchandise, consumers can still find toys, candy. In addition, consumers can buy more health-focused products, such as medical equipment and supplies for diabetes care and sleep apnea.

After acquiring Aetna in November, CVS promised to transform its stores to improve the health of its customers and lower healthcare costs. (Feb 13 Beckers)


Dr. Millar Appears on Local TV Health Show
Onondaga Medical Society President Dr. MaryAnn Millar appeared as a guest on a local TV show Bridge Street; Your Health to talk about the Onondaga County Medical Society and their mission to help their community.

DFS Emergency Adoption Calling for 18 Month Delay of WC Fee Schedules
Please see the following regarding Department of Financial Services’ (DFS) emergency adoption calling for an 18-month delay of the WC medical fee schedules for NYS No-Fault Auto cases-

Charges for Professional Health Services

Date Published in State Register: February 27, 2019

Contact: Camielle Barclay

The notice of proposed rule for No-Fault Auto will be published in the NY State Register on February 20, 2019 with a public comment period, open until April 22, 2019.  Based on this proposed rule, DFS is delaying adoption of the update WC medical fee schedules until October 1, 2020.  Therefore, physicians who treat NYS auto accident victims will need to use the current/existing WCB fee schedule which became effective on June 1, 2012.  This is the link for the NY State Register:  https://www.dos.ny.gov/info/register/2019.htmlOnce the February 20, 2019 notice is published, you will be able to submit your comments to DFS regarding the delayed adoption.


Medicine Innovation & Entrepreneurship Conference Saturday April 27th, 8-5 pm
We invite Physicians interested in innovation & entrepreneurship to join fellow physician innovators at the first start up conference for doctors by doctors. The MIE physician speakers, who have a proven track record of successfully starting their own endeavors, have volunteered their time to help doctors in the healthcare innovation space. A complete list of speakers can be found on the website. We also will be featuring an investor / venture capitalist panel for any physicians who are looking for funding for their innovative idea. Only 50 spots remaining.

Healthcare innovation is not just for tech giants and we want to help our fellow physicians bring their ideas to life. Come join us for this transformative event!

RSVP at www.medicineandtech.com with discount code MSSNY for 15% off all registration categories.


Universal Healthcare in CA Would Cost $17 Billion Annually, Analysis Suggests
The San Francisco Chronicle (2/8) reported, “Universal health care in California could cost $17.3 billion a year,” according to a proposal put forward by health policy researchers at UC Berkeley. Under the plan, some 3 million uninsured Californians would gain access to healthcare coverage.

The article said this is one of several recent analyses. This one differs from the others in that universal healthcare is estimated to cost about twice as much, given that it “builds in the assumption that the uninsured would get on private health insurance plans, whereas other estimates factor in federal funding for getting more people on Medi-Cal, which is jointly paid for by the federal and state governments.”


New WC Medical Fee Schedule
The Chair adopted an updated Workers’ Compensation Medical Fee Schedule on December 26, 2018. The new Medical Fee Schedule will be effective for services provided on or after April 1, 2019. The new WC fee schedule is an increase of 10-37% for physicians.

The Board adopted the use of ICD-10 October 1, 2015, as previously announced in Subject Number 046-785 Chair Announces Adoption of ICD-10. Therefore, effective April 1, 2019, the Board will require full compliance with ICD-10.

The Workers’ Compensation Medical Fee Schedule is published by Optum Insight. Copies may be obtained by mail, telephone, or online.

By mail, write to: Official New York Workers’ Compensation Fee Schedule, PO Box 88050,
Chicago, IL 60680-9920 By phone: Call (800) 464-3649, option 1.

Online: Go to www.optum360coding.com, keyword New York, or https://www.optum360coding.com/Product/40508/.

Clarissa M. Rodriguez
Chair WCB


 

Classified

RENTAL/LEASING SPACE

Office Rental 30 Central Park South.
Two fully equipped exam, two certified operating, bathrooms and consultation room.  Shared secretarial and waiting rooms. Elegantly decorated, central a/c, hardwood floors. Next to Park Lane and Plaza hotels. $1250 for four days a month. Available full or part-time. 212.371.0468drdese@gmail.com.


5th Ave Medical Office for Share
Facing Central Park in exclusive building, ground floor, separate entrance.
Perfect for psychiatrist, physiatrist, osteopath, or other.
880 5th Avenue (between 69th and 70th Sts.), New York, N.Y.
Please call 917-715-2464


Rare Find — Great Office Share
Wonderful office share in terrific location at great price. Available Monday, Wednesday, Friday and weekends. Choice of smaller windowed consultation room with adjoining exam room or big windowed consultation room with one or two exam rooms. Beautiful bright rooms, lovely reception area and front . First-rate building on 58th Street between Park and Lexington. Rent by day (about $180). Front desk and office management available if needed, along with many other amenities, including internet, ultrasound, EMG Kitchen, optional C Arm. Willing to make changes for new tenant. Call 646-642-0700.


Are You Trying to Lease Your Medical Office or Sell Your Medical Practice? Trying to Sell New or Used Medical Equipment?
Clineeds, the new online platform designed for medical providers. With Clineeds you can lease your medical officeshared your office spacebuy and sell used medical equipment, or post healthcare job opportunities. LISTING IS FREE! Why wait? Click here to sign-up: www.clineeds.com/sign-up


PHYSICIAN OPPORTUNITIES

Pediatrician BC, P/T
Seeking motivated, enthusiastic pediatrician for P/T position in solo practice in Long Island. Coverage will increase over time. Great opportunity for those seeking part time hours in an established practice.   Fax resume to 516-858-2389.


Physician Wanted to Help Shape the Future of Primary Care
98point6 is a healthcare technology company committed to delivering more affordable, accessible, high-quality primary care. To support our mission, the insights of forward-thinking physicians like you are invaluable. Members of our exclusive Primary Care Council have no clinical responsibilities and are generally compensated for participation, which requires only a few hours per year.

Interested? Learn more and apply today at www.98point6.com/pcc


Avoid nuisance lawsuits!! Make sure your website is compliant with the Americans with Disabilities Act! We can do a free audit of your website and let you know if corrections are needed. Call 516-830-1973 or visit tinyurl.com/ADAWebsiteHelp for more information.


CALL FOR RATES & INFO. CHRISTINA SOUTHARD: 516-488-6100 ext. 355

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 


MSSNY Statement on Revised New York Health Act Legislation


MSSNY Seal
MEDICAL SOCIETY OF THE STATE OF NEW YORK
865 Merrick Avenue, Westbury, New York 11590-9007
www.mssny.org
Communications Division
Telephone: (516) 488-6100

 

 

February 11, 2019
For Immediate Release

MSSNY Statement on Revised New York Health Act Legislation

Statement attributable to:

Thomas Madejski, MD
President, Medical Society of the State of New York

“The revised New York Health Act legislation announced today contains some improvements including changes to address some of the concerns raised by physicians with the potential enactment of such a far-reaching proposal.  This includes parameters to limit burdensome prior authorization requirements and some additional steps to facilitate fairer negotiations between a government bureaucracy and the physicians delivering care.

Nevertheless, while we are aware that physician perspectives vary, MSSNY continues to have a long-standing policy in support of a multi-payor insurance system to achieve universal coverage and in opposition to a single payor system.  MSSNY also has policy that calls on it to study the feasibility of varying systems for achieving universal coverage which includes single payor.

In this regard, MSSNY will continue to assess the strengths and weaknesses of this and other proposals to achieve universal health insurance coverage.  There are many dynamics to this issue that must considered.  There are huge ramifications not only for patients considering their options for receiving needed care, but also for physicians and other health care providers deciding in which states they would like to deliver patient care.  MSSNY is committed to working with Assemblyman Gottfried, Senator Rivera, the Legislature and the Governor to enhance New Yorkers’ ability to obtain comprehensive health insurance coverage that enable patients to receive needed care from the physician of their choice.”

# # #

About the Medical Society of the State of New York
Founded in 1807, the Medical Society of the State of New York is the state’s principal non-profit professional organization for physicians, residents and medical students of all specialties. Its mission is to represent the interests of patients and physicians to assure quality healthcare services for all.

Media Contact:
Roseann Raia

Medical Society of the State of New York
865 Merrick Ave.
Westbury, New York
516.488.6100 x 302
rraia@mssny.org

 

Feb. 8, 2019 – Women and Children First!

Thomas J. Madejski, MD MSSNY President
PRESIDENT’S MESSAGE
Thomas J. Madejski, MD
MSSNY President


MSSNY eNews
February 8, 2019
Volume 22  Number 6

MSSNYPAC Seal

Colleagues:

I need your help.  I need you to join me in Albany March 6th to meet with our elected officials about the health and safety of our patients Click Here to Register! New York Governor Andrew Cuomo @NYGovCuomo has proposed his budget for New York State and the NYS legislature has started budget hearings on a multitude of issues affecting the health and welfare of our patients and our profession.  These issues are currently under discussion and MSSNY has provided testimony on a number of items of concern. I’ve indicated to you in some of my previous communications the importance of building relationships with our elected officials in the markedly changed legislative environment during the new session. Our representatives and their staff need to understand the potential effects of their proposals on our patients and families and their constituents.

Our excellent MSSNY legislative staff does a great job in getting information about our greatest concerns to our elected officials. The most critical part of advancing our goals for the betterment of public health and the proper practice of medicine is direct interaction with your personal representatives.  March 6th is our best opportunity to demonstrate our care of, and care about, our patients. We have an opportunity to weigh in on reducing maternal mortality, advocating for the care of women and their infants, and to reduce the incidence of exposure to psychoactive substances to our children and young adults.  Let me assure you that the situation is fluid, and your individual effort can make a difference in the health of your patients, your satisfaction in your practice, and the health of our communities.

Please sign up to join me in Albany March 6th.  Your patients, and our profession, are counting on us.

P.S. I’d be honored if you would also join me in Albany for our MSSNY Council meeting March 5th.  Let me know if you’re coming, and any other thoughts you have.

You can follow me on twitter@tommadejski

lux, veritas, virtuslegis plenitudo charitas

Comments? comments@mssny.org; @mssnytweet; @TomMadejski

Thomas J. Madejski, MD
MSSNY President



MLMIC Banner


Capital Update

MSSNY Delivers Testimony Highlighting Positives and Negatives of New York State Budget Proposal
MSSNY Senior Vice President and Chief Legislative Counsel Moe Auster delivered testimony this week to a joint Senate-Assembly Committee regarding the healthcare portion of Governor Cuomo’s proposed 2019-20 budget. MSSNY’s testimony applauded the several positive measures included within the budget that MSSNY believes will help physicians provide better care to New Yorkers, while also highlighting a list of issues deemed problematic to the medical community and their patients.

To view MSSNY’s testimony and the several questions from legislators,  Click here.  To read MSSNY’s written testimony, Click here.

Of note, MSSNY’s testimony noted its support for NYS Executive Budget measures that would: increase the tobacco/e-cigarette purchase age to 21, provide better coverage of care for mental illness and substance abuse treatment, examine ways to prevent maternal mortality, provide stronger regulation of pharmaceutical benefit managers (PBMs) and extend the Excess Medical Malpractice Insurance program to assist physicians in affording extraordinarily expensive but needed liability insurance coverage.

MSSNY’s testimony also expressed strong concerns with proposals that would legalize the non-medicinal use of marijuana, revoking from doctors the final say in coverage for prescribing medications to their Medicaid insured patients and expansion of the types of practitioners who could treat Workers Compensation patients without addressing the numerous factors that are deterring physician participation in this program.  He particularly highlighted the physician community’s strong concerns with a proposal that would significantly cut (an estimate $80 per patient cut) the patient deductible payments that Medicaid makes to physicians who treat patients dually eligible for Medicare and Medicaid.

Mr. Auster answered a variety of questions from the legislative panel, including the physician perspectives on the legalization of non-medicinal marijuana; the regulation of pharmaceutical benefit managers, and perspectives on single payer legislation. (DIVISION OF GOVERNMENTAL AFFAIRS)


Physicians Urged to Oppose Further Dual Eligible Payment Cuts Proposed in State Budget
All physicians are urged to contact their state legislators to urge that they reject a proposal contained in the 2019-20 Executive Budget that would significantly cut the payments that Medicaid makes to physicians to cover the Medicare Part B deductibles of their “dually eligible” patients.   You can send a letter in opposition by clicking Here.

You can read MSSNY’s memo of opposition to the Legislature Here.

While the exact cut for each physician would depend on the physician’s patient mix and services provided, we estimate that the cut would be $80 per patient.  That is because the 2019 Medicare Part B deductible is $185, and studies show that on average Medicaid only pays 56% of the Medicare fee schedule in New York.

Given that there are hundreds of thousands of patients in New York who are “dually eligible”, for practices that see a large number of dual eligible patients, this will have a profound impact.  For example, if a physician’s patient mix includes 500 such dual eligible patients, which could certainly be the case for many types of specialty physicians, that amounts to a decrease of over $40,000 per year – funds that could go toward upgrading electronic health records, hiring additional staff to allow for more time with patients, upgrading facilities or other medical equipment. In past years, physicians have had to absorb significant cuts from Medicaid for the care that they provide to their senior and disabled patients covered by both Medicare and Medicaid, making it much harder for these physicians to deliver community-based care. Please urge your legislators know how unfair this cut is.  Please urge them to oppose balancing the state

budget on the backs of dedicated community physicians seeking to deliver quality care to their patient.
(AUSTER)


Medical Liability Reform Bills Introduced in the Assembly
Assemblymembers Robin Schimminger (D-Kenmore) and Peter Abbate (D-Brooklyn) each re-introduced legislation this week aimed at reducing the exorbitant cost of medical liability insurance in New York State, and providing more fairness in the resolution of the cases.

In New York, cumulative medical liability payouts far outpace other states. A recent report by Diederich Healthcare showed that, in 2017, once again New York State had far and away the highest number of cumulative medical liability payouts. Claimants in New York were awarded nearly two times more than the state with the next highest amounts, Pennsylvania, and payments in New York far exceeded states such as California and Florida. Moreover, New York had the dubious distinction of having the highest per capita medical liability payouts in the country, about 500% greater than the State of California, which has enacted meaningful liability reforms.

Assemblyman Schimminger’s Medical Liability Reform Act (A.4897) would work to ease the extraordinary liability burden on physicians in New York through the enactment of a number of policy changes, including the following:

  • Requiring an affidavit of merit from a NY licensed physician to cut down on the filing of non-meritorious claims;
  • Placing a reasonable limit on non-economic damages (there are currently 30 states with some form of a similar cap); and
  • Requiring enhanced disclosure of identity of expert witnesses

Assemblyman Abbate’s legislation (A.5018) would require a particularized affidavit of merit to function as a comprehensive vetting of medical malpractice claims prior to commencing of a legal action. Additionally, it would require full and complete discovery of expert witnesses in medical liability actions.                            (AVELLA, AUSTER)                     


State Lobby Day Banner


New York State insurance exchange reports record enrollment numbers
NY State of Health’s open enrollment period ended on January 31, and at that time enrollment in both the Essential Plan and in Qualified Health Plans had increased over last year. Essential Plan enrollment stood at 790,152, up 6.9% over last year meanwhile 271,873 people had purchased Qualified Health Plans, a 7.4% increase compared to the same point last year. In contrast, enrollment dropped by 3.8% in the 39 states that use the federal marketplace. The Essential Plan provides coverage with no deductible and is either free or costs $20 monthly. A family of four earning up to $50,200 qualify and New York and Minnesota are the only two states to offer this option. According to the Kaiser Family Foundation, the monthly premium for the cheapest individual bronze Qualified Health Plan in NY averages $402 without subsidies and the cheapest gold plan averages $638 per month. NYSOH has stated that 58% of people buying plans qualify for financial assistance.      (AVELLA)


Experts Debate New York Health Act
Click here to watch a 2-hour debate of the proposed New York Health Act sponsored by the New York City Bar Association please Click here.  Participants in the program included NYS Assembly Health Committee Chair Richard Gottfried, sponsor of the legislation; Eric Linzer, President of the New York Health Plan Association; Bill Hammond, Director of Health Policy for the Empire Center for Public Policy; Dr. Oliver Fein, Chair of the NY-Metro Chapter of Physicians for a National Health Plan; and Ashley Fox, an Assistant Professor at University at Albany.                       (AUSTER)     


Workers Compensation Board Looks at Improvements to the IME Process
This week the initial meeting of the New York Workers’ Compensation Board IME Advisory Committee took place.   Among the members of the WCB expert panel was MSSNY Past-President Dr. Robert Goldberg.  The group was created pursuant to a provision of the comprehensive Workers Compensation legislation enacted in 2017 that called on the WCB to make recommendations for improving the process by which injured workers receive independent medical examinations.   In particular, the statute calls upon the Board to develop recommendations “that will ensure fairness, and highest medical quality, while improving methods of combatting fraud”For example, one of the major discussion points for the initial meeting this week was examining data that a small number of practitioners had performed an enormous number of IMEs.  The group will be meeting throughout 2019 to develop recommendations for improving the IME process with a report due to the Governor & Legislature by year end. (AUSTER)


Medical Jobs Ad

MSSNY Fights for Funding to Attract and Retain Physicians in NYS
This week MSSNY staff joined representatives from a variety of other health care advocacy groups (including HANYS, NYACP, CHCANYS, the Center for Health Workforce Studies & the Upstate NY Physician Recruiter Network) in numerous meetings with key legislative and executive staff to support increased efforts to address the shortage of physicians in underserved regions across New York State. In addition, two physicians who are Doctors Across New York (DANY) awardees joined the group and shared their stories about how DANY positively affected their lives and ability to practice in New York. Among the notable issues was the request of legislative support of funding for DANY.

DANY is a state funded program launched in 2008 that aims to train and place physicians in areas of New York State where that specialty is most needed. The goal is to ensure adequate funding, streamline the application process and to remove barriers to application. The group is also hoping for increased funding for the Empire Clinical Research Investigator Program (ECRIP) which allows doctors to spend additional time training in research.

Other priorities for the group include funding for the Diversity in Medicine Scholarship; the expansion of the Take a Look Program, which introduces medical students and residents practicing in NYC to Upstate New York and the opportunities available in medicine; and statutory implementation of required data collection for allied health workers.                                                                      (HARRING, AVELLA)


Senator Rivera Introduces Legislation to Improve Patient Access to be Treated by the Physician of Their Choice
Senator Gustavo Rivera, Chair of the New York State Senate Health Committee, introduced three bills this week that are strongly supported by MSSNY. The bills in question relate to health insurance networks and the interaction between physicians and insurance companies.

  • S3461 would require that health insurers cover services provided by out-of-network (OON) providers. OON coverage is not mandated in New York and while exchange officials have “strongly encouraged” insurers to offer this coverage, many New Yorkers do not have this option available. Additionally, many patients are restricted to limited physician networks that do not provide adequate choice of physician to receive their care.
  • S3462 would allow in limited instances independently practicing physicians in New York State to conduct some collective negotiations by creating a system under which the state would closely monitor those negotiations, and approve or disapprove such negotiations from going forward. Many areas of New York are dominated by a small number of insurers and this bill would help even the playing field between physicians and insurers.
  • S3463 would provide physicians due process protections when health insurers seek to terminate a physician from its network by failing to renew the physician’s contract. Current law prohibits a health insurance company from terminating a physician’s contract without a written explanation of the reasons for the proposed contract termination and an opportunity for a hearing by a panel comprised by three persons including a clinical peer in the same or similar specialty. These provisions, however, do not apply to situations involving the non-renewal of physician contracts. This bill would correct that disparity.                            (AVELLA)

NYS Senate Commitee to Consider Bill Mandating Patient Education for C-Section; Physician Action Urged
Senate Bill 2888/A.318, sponsored by Senator Julia Salazar and Assemblymember Amy Paulin, would require all physicians and other health care providers to provide all maternity patients with written information as to the risks associated with Cesarean section. This measure is before the Senate Women’s Issues Committee and has already passed the NY State Assembly. The Medical Society of the State of New York & ACOG are opposed to this measure as it interferes with the physician patient relationship by requiring a written communication to every single pregnant women whom the physician recommends a  C-Section. MSSNY & ACOG are concerned that a individual patient may have different risk factors and health needs.

Furthermore, the terminology of the bill is not consistent with the typical medical practice.  The Medical Society is also troubled by the proliferation here in New York State, and nationally, calling for legislation requiring educational information that physicians will need to cite that pertains to women’s health issues.  Nationally, a disproportionate number of these bills apply only to physicians when they are treating pregnant women.  Furthermore, states have gagged or coerced physician communications for politicized public health issues.

This measure mandates physicians to provide “a script” that may not comply with the latest medical evidence on Cesarean section. Physicians are urged to contact members of the Senate Women’s Issue Committee which are:  Senator Julia Salazar, Senator Betty Little, Senator Shelley Mayer, Senator Anna Kaplan, Senator Catherine Young, Senator Jen Metzger, and Senator James Gaughon. They can be reached through the main senate switchboard at (518) 455-2800 or by sending a letter through the MSSNY Grassroots Action Center at this link please Click here.                (CLANCY)   


CPH Banner

NYS Reproductive Health Act; Governor Discusses Aspects of the Law
The New York State Legislature passed the Reproductive Health Act and it was immediately signed into law by Governor Andrew Cuomo as Chapter 1, Laws of 2019.    The law amended the public health law by codifying the abortion procedure within New York State’s public health law and removing it from the penal law.  The same provisions found in Roe v. Wade remain in same.  The law creates a statement of purpose and says that an abortion may be performed by a licensed, certified or authorized practitioner acting within their defined scope of practice under Title 8 of the Education Law. Under the new law, an abortion can be performed:

  1. a) within 24 weeks from the commencement of pregnancy;
  2. b) at any time, where there is an absence of fetal viability; or
  3. c) at any time, when necessary to protect the patient’s life or health.

This is consistent with what previous Supreme Court decisions have held.

Gov. Andrew Cuomo this past week wrote an op-ed about the law in the NY Times including responding to comments misinterpreting what the law does.   His op-ed can be found  Here.

MSSNY has a long standing policy that opposes the criminalization of the exercise of clinical judgement in the delivery of medical care.   Moving the abortion procedure from the State Penal law to the Public Health Law is consistent with this position.   The law does not expand the current scope of practices for health care providers.  It does, however, specify that health care practitioners can perform an abortion if it is otherwise enabled by their current scope of practice as defined under the NYS Education Law. Nurse practitioners are allowed to perform a medicated abortion procedure already under their scope of practice.  However, nurse practitioners’ scope does not include “surgery” and cannot perform a surgical abortion.   The American College of Obstetricians and Gynecologists (ACOG) District II and the NYS Academy of Family Physicians (NYAFP)  supported this measure.  MSSNY will be closely monitoring the implementation of the new law to assure health care practitioners are acting within their scope. (CLANCY) 


Measles Outbreak in New York State Continues to Spread Webinars Available at MSSNY CME Website
The measles outbreak in New York State continues to spread with at least 186 confirmed cases as of last week.  There have been 124 in Rockland County and 62 cases in Brooklyn with one suspected case currently being monitored.  While New York State has a statewide vaccination rate of about 90% for Measles, the communities mainly affected by the current outbreak are only at about 60%.  MSSNY conducted a just-in-time Medical Matters webinar entitled “The Continued Public Health Threat of Measles 2018” in December, 2018.  This webinar has now been posted to the MSSNY CME website.

Additionally, be sure to watch The Importance of Herd Immunity, another Medical Matters posting that delves into how herd immunity works and why it is integral to the elimination of vaccine-preventable diseases.  Please check both of these programs out and keep yourself informed about the ongoing measles outbreak throughout New York State and the country.  You can also listen to MSSNY’s brief podcast on the Measles, Mumps and Rubella vaccine please Click here. (HOFFMAN, CLANCY)


“What’s Your Diagnosis? Psychological First Aid” Interactive CME webinar February 20, 2019 @7:30am – Registration now open
Be sure to register for the next Medical Matters interactive webinar, What’s Your Diagnosis? Psychological First Aid.  This program will include interactive components for participants.  You will be asked to answer questions about a case and discussion will follow.  Find out if you’re fully prepared to include psychological first aid during an emergency on February 20th at 7:30am.

Registration is open for this program please click Here.

Faculty will be Craig Katz, MD, co-vice chair of MSSNY’s Committee on Emergency Preparedness and Disaster/Terrorism Response.

Educational Objectives:

  • Describe the basic tenets of psychological first aid (PFA)
  • Identify resources to assist patients during and after trauma
  • Describe a scenario and review questions and answers

The Medical Society of the State of New York is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.

The Medical Society of the State of New York designates this live activity for a maximum of 1.0 AMA/PRA Category 1 credits™.  Physicians should claim only the credit commensurate with the extent of their participation in the activity. 

(DIVISION OF GOVERNMENTAL  AFFAIRS)


Registration Now Open for New Veterans Matters CME Webinars
The Medical Society of the State of New York is proud to announce two NEW Veterans Matters webinars scheduled for February and March 2019. These webinars are: The Special Mental Health Needs of Women Veterans on Thursday, February 28th at 7:30am and Military Culture: Everything Physicians Need to Know About Veterans as Patients on March 14th at 7:30am.  Register Here

for The Special Mental Health Needs of Women Veterans, and Register Here.

for Military Culture: Everything Physicians Need to Know About Veterans as Patients.



NY Rx Card Banner


For more information relating to any of the above articles, please contact the appropriate contributing staff member at the following email addresses:

pschuh@mssny.org mauster@mssny.org  pclancy@mssny.org  mavella@mssny.org
charring@mssny.org

eNews

MSSNY, AMA and Medical Societies Fight to Assure Fair Resolution of Surprise Medical Bills Issue
Led by United States Senator William Cassidy, MD (R-LA), the US Senate has been examining proposals that would address surprise out of network medical bills faced by patients in hospitals, usually the result of being treated by an out of network specialist in the emergency department or other unanticipated care.

Many believe that this is one of the only health care issues in the current Congress that has bipartisan support.

To that end, MSSNY has written to the New York Congressional delegation, urging that any legislation to be considered is consistent with New York’s comprehensive law on the subject enacted in 2014 (see MSSNY’s letter here: http://www.mssnyenews.org/wp-content/uploads/2019/02/0349_001.pdf).   New York’s comprehensive law addressing this issue has been hailed as a model for the rest of the country because of the delicate balance it struck among key health care stakeholders (such as physicians, hospitals and health insurers) to protect patients from large “surprise” medical bills, while at the same time being constructed in such a way that it did not adversely affect the ability of hospital emergency departments to have adequate on-call specialty physician care.

In addition, MSSNY has also joined on to a federation of medicine letter to the US Congress initiated by the American Medical Association along with over 60 other national specialty societies and over 40 other state medical societies urging that the any legislation to be considered by Congress meet a series of key principles.  These principles recognize the multitude of factors that can lead to patients facing unanticipated out of network medical bills: including assuring health insurers maintain robust physician networks, assuring health insurers maintain accurate provider directories; assure patients are kept “out of the middle”, and assure that any guidelines or limits on what out-of-network providers are paid should reflect actual charge data for the same service in the same geographic area from a statistically significant and wholly independent database, and not be based on Medicare or in-network rates.

MSSNY physician leaders will be in Washington DC next week along with physician leaders across the country to visit with their respective Congressional delegations on this critical issue and other key health care issues before Congress.


What’s next for DSRIP?
State Department of Health officials said they plan to pursue an additional five-year federal waiver ahead of the expiration of the $7.4 billion Medicaid Delivery System Reform Incentive Payment program in April 2020. In the meantime, the governor’s fiscal 2020 budget proposal includes several provisions to advance the DSRIP goal of reducing avoidable hospital use by 25% compared to the state’s baseline in 2015.

So far the state’s 25 Performing Provider Systems—groups of hospitals, physicians, health centers and community organizations—have reduced unnecessary hospitalizations by 17%, said Greg Allen, director of program development and management at the state Department of Health, during a webinar budget briefing.

“Many Performing Provider Systems have been engaged in conversations in what a future DSRIP program could look like,” he said. “Clearly there’s an interest by all stakeholders in continuing the best of what’s happened here. Just about everyone agrees we should ask for renewal.”

Allen noted that several other states have had their federal waivers renewed. He said health care providers’ value-based contracts with insurers were “not quite mature enough” to finance the types of programs providers are pursuing. As part of the budget, the state Department of Health plans to promote best practices from providers that have been able to keep their patients out of the hospital, which it estimates will save $10 million for Medicaid next year. The department also plans to lower Medicaid payments to facilities that have high rates of avoidable hospitalizations. It would use the $5 million it expects in savings to invest in primary, maternity and ambulatory care. (Crains)


 


Garfunkel Ad


SAVE THE DATE: MSSNY’s Annual “Physician Advocacy Day” (3/6)!
With nearly 40 newly elected legislators in Albany, the need for physician advocacy and grassroots involvement is greater than ever. With so much new representation, it’s vital for physicians to forge new relationships, as well as strengthen existing relationships with this new Legislature to ensure the physician community’s message is well-represented.

One opportunity is to participate in MSSNY’s “Physician Advocacy Day” that will be held on Wednesday, March 6th in the Lewis Swyer Theatre in the Egg located at the Empire State Plaza, Albany NY. Click HERE to register!

Join your colleagues from all around New York State and come to MSSNY’s Physician Advocacy Day to speak with your legislators and key policymakers to ensure they’re making the right choices for New York’s physicians and their patients.

Join us to urge your legislators to:

  • Proceed very cautiously on paradigm shifting proposals such as legalization of recreational marijuana (proposed in the State Budget) and creating a single payor health insurance structure.
  • Reject unfair cuts to physicians treating patients covered by both Medicare and Medicaid;
  • Reject proposals that would add prior authorization burdens for care provided to Medicaid patients;
  • Support legislation to reduce excessive health insurer prior authorization hassles that delay patient care.
  • Reduce the high cost of medical liability insurance through comprehensive reforms.
  • Reject burdensome mandates that interfere with patient care delivery.
  • Preserve opportunities for medical students and residents to become New York’s future health care leaders.

A brief luncheon to which members of each House are invited to speak with their constituents will follow the morning program. County Medical Societies will be scheduling afternoon appointments for physicians to meet with their elected representatives.                                                                       (HARRING)

If you have any questions, please contact Carrie Harring: charring@mssny.org.


NY County President Dr. Van De Walle Welcomes Legislators

Naheed-Van-De-Walle-MDThe President of the New York County Medical Society Naheed Van De Walle MD at the podium at the Legislative Breakfast held on January 27. 

The event featured a lineup of Manhattan legislators including Assembly Health Chair Dick Gottfried, US Representative Carolyn Maloney, Manhattan Borough President Gale Brewer, and Senate Health Chair Gustavo Rivera.  

Other speakers were New York City Councilman and physician Matthieu Eugene, Senator Robert Jackson and Assemblymember Harvey Epstein.  Over 70 physicians from New York County Medical Society and co-sponsoring organizations NY City Psychiatric Society and the New York Council on Child and Adolescent Psychiatry were in attendance to question legislators on everything from single payer, drug formularies, marijuana, and other important physician issues.

Presidents of all three organizations actively participated in the session. According to Dr. Van de Walle, the success of the breakfast was a product of the hard work and dedication of the organizers from all three organizations which included, Cheryl Malone, Meagan O’Tolle, Susan Tucker, Vera Fuer and other dedicated NYCMS staff such as Lisa Joseph. Although representatives from a number of organizations attended the breakfast, the initial feedback was that it was the best Legislative breakfast they had attended to date.


Anthem Tops Fourth Quarter Expectations
The Blue Cross-Blue Shield insurer Anthem topped fourth-quarter earnings expectations and unveiled a better-than-expected 2019 forecast, helped by an early start for its prescription drug coverage business. Shares of the nation’s second-largest health insurer soared after Anthem said Wednesday that it will start moving customers into its new business in this year’s second quarter, several months ahead of schedule.

The insurer has said that it expects to gain annual savings of more than $4 billion by running its own pharmacy benefit management operation, which it calls IngenioRx.

Anthem initially anticipated a 2020 start for its PBM business, which it will run with help from CVS Health Corp. But it said Wednesday that it was ending its deal with Express Scripts on March 1 due to that company’s recently completed acquisition by another insurer, Cigna Corp. Anthem Inc. covers nearly 40 million people, including those who receive private insurance or benefits from the government-run Medicaid and Medicare programs. (AP 2/7)


Determining Whether Older Medical Professionals Can Competently Perform
The New York Times (2/1) reports that some hospitals are using “mandatory screening procedures” to assess whether medical professionals older than 70 can perform competently, with many of those professionals “unenthusiastic about the idea.” The Times says mandatory screening – generally beginning at age 70 –has already begun at “the University of Virginia Health System, Temple University Hospital and UPMC in Pittsburgh.” Screening generally covers physicians as well as physician assistants, nurse practitioners, and other roles.


Researchers Find Increasing Risk of Obesity-Related Cancers
The New York Times (2/4) reports on a study published in Lancet Public Health finding that “the risk of developing obesity-related cancer is increasing in successive generations, along with increasing rates of obesity.” Investigators “studied the incidence of 30 of the most common cancers, including 12 that are obesity related, from 1995 to 2014 in people ages 25 to 84 — more than 14.6 million cases.” The investigators “found that for six of the 12 obesity-related cancers (multiple myeloma, colorectal, uterine, gallbladder, kidney and pancreatic) the risk for disease increased in adults 25 to 49, with the magnitude of the increases steeper with younger age.”


E-Cigarettes Outperform Nicotine Replacement for Smoking Cessation
Adults who smoke conventional cigarettes are more likely to quit smoking successfully when they use electronic cigarettes rather than nicotine replacement therapy (NRT) as a quit aid, according to a randomized trial in the New England Journal of Medicine. Nearly 900 U.K. adults who were looking to stop smoking were randomized to use e-cigarettes or NRT beginning on their quit date. The e-cigarette group was given a starter pack but could then use the product of their choice, while NRT participants could choose their preferred product. All participants also received at least four weekly sessions of behavioral support.

The primary outcome — the rate of abstinence at 1 year confirmed by carbon monoxide levels — favored the e-cigarette group (18% vs. 9.9% in the NRT group).

NEJM article

Classified

RENTAL/LEASING SPACE


5th Ave Medical Office for Share
Facing Central Park in exclusive building, ground floor, separate entrance.
Perfect for psychiatrist, physiatrist, osteopath, or other.
880 5th Avenue (between 69th and 70th Sts.), New York, N.Y.
Please call 917-715-2464


Rare Find — Great Office Share
Wonderful office share in terrific location at great price. Available Monday, Wednesday, Friday and weekends. Choice of smaller windowed consultation room with adjoining exam room or big windowed consultation room with one or two exam rooms. Beautiful bright rooms, lovely reception area and front . First-rate building on 58th Street between Park and Lexington. Rent by day (about $180). Front desk and office management available if needed, along with many other amenities, including internet, ultrasound, EMG Kitchen, optional C Arm. Willing to make changes for new tenant. Call 646-642-0700.


Are You Trying to Lease Your Medical Office or Sell Your Medical Practice? Trying to Sell New or Used Medical Equipment?
Clineeds, the new online platform designed for medical providers. With Clineeds you can lease your medical officeshared your office spacebuy and sell used medical equipment, or post healthcare job opportunities. LISTING IS FREE! Why wait? Click here to sign-up: www.clineeds.com/sign-up


PHYSICIAN OPPORTUNITIES

Pediatrician BC, P/T
Seeking motivated, enthusiastic pediatrician for P/T position in solo practice in Long Island. Coverage will increase over time. Great opportunity for those seeking part time hours in an established practice.   Fax resume to 516-858-2389.


Physician Wanted to Help Shape the Future of Primary Care
98point6 is a healthcare technology company committed to delivering more affordable, accessible, high-quality primary care. To support our mission, the insights of forward-thinking physicians like you are invaluable. Members of our exclusive Primary Care Council have no clinical responsibilities and are generally compensated for participation, which requires only a few hours per year.  Interested? Learn more and apply today at www.98point6.com/pcc


Avoid nuisance lawsuits!! Make sure your website is compliant with the Americans with Disabilities Act! We can do a free audit of your website and let you know if corrections are needed. Call 516-830-1973 or visit tinyurl.com/ADAWebsiteHelp for more information.


CALL FOR RATES & INFO. CHRISTINA SOUTHARD: 516-488-6100 ext. 355